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Individual

JEFFREY D ARENDELL

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DO

Contact information

Practice address
2100 MADISON AVE, GRANITE CITY, IL 62040-4701
(618) 798-6300
(618) 798-3716
Mailing address
6713 STONERIDGE EST, COLUMBIA, IL 62236-2905
(618) 476-1967

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
036086735
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
036086735-3
IL
01
3932056
BLUE SHIELD
IL
Enumeration date
07/26/2006
Last updated
01/21/2009
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