Individual
DR. JUAN ALFREDO CARRILLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
302 BROADWAY ST, MOUNT VERNON, IL 62864-5116
(618) 242-4750
(618) 242-7674
Mailing address
302 BROADWAY ST, MOUNT VERNON, IL 62864-5116
(618) 242-4750
(618) 242-7674
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
036049441
IL
Other
Enumeration date
08/12/2008
Last updated
08/12/2008
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