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Individual

DR. BETH ANN CONNELL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
DC

Contact information

Practice address
NORTH MILL STREET, UTICA, IL 61373
(815) 667-4819
Mailing address
NORTH MILL STREET, UTICA, IL 61373
(815) 667-4819

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
2549
KY
111N00000X
Chiropractor
Primary
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
5082021
BCBS PROVIDER #
Enumeration date
12/04/2006
Last updated
07/08/2007
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