Individual
MADISON ROSE FUNNEMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
300 W OAK ST, CARBONDALE, IL 62901-1400
(618) 536-6621
Mailing address
300 W OAK ST, CARBONDALE, IL 62901-1400
(618) 536-6621
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
125084013
IL
Other
Enumeration date
06/03/2024
Last updated
06/03/2024
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