Individual
LAURA BIRD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
2 MEMORIAL DR STE 220, ALTON, IL 62002-6723
(618) 433-7901
(618) 433-7940
Mailing address
PO BOX 959203, SAINT LOUIS, MO 63195-9203
(618) 433-7901
(618) 433-7940
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
036096129
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036096129
—
IL
Enumeration date
09/19/2005
Last updated
10/28/2025
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