Individual
JEANINE CONNOLLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2320 HIGH ST, BLUE ISLAND, IL 60406-2426
(708) 388-5500
(708) 388-5672
Mailing address
2320 HIGH ST, BLUE ISLAND, IL 60406-2426
(708) 388-5500
(708) 388-5672
Taxonomy
Speciality
Code
Description
License number
State
207RR0500X
Rheumatology Physician
Primary
036104880
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036104880
—
IL
01
—
P00156797
RAILROAD MEDICARE
IL
Enumeration date
04/11/2006
Last updated
01/24/2011
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