Individual
DR. MECHELLE E ELOSIEBO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
3 SAINT ELIZABETH BLVD STE 4000, O FALLON, IL 62269-1284
(618) 233-5480
(618) 222-4790
Mailing address
3 SAINT ELIZABETH BLVD STE 4000, O FALLON, IL 62269-1284
(618) 233-5480
(618) 222-4790
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
036142813
IL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
06/23/2009
Last updated
03/09/2018
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