Individual
DR. EILEEN ANNE O'HALLORAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
607 S NEW BALLAS RD STE 2350, SAINT LOUIS, MO 63141-0001
(314) 251-1340
Mailing address
607 S NEW BALLAS RD STE 2350, SAINT LOUIS, MO 63141-0001
(314) 251-1340
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
036.134096
IL
208600000X
Surgery Physician
Primary
2024028245
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
036.134096
ILLINOIS DEPARTMENT OF FINANCIAL AND PROFESSIONAL REGULATION
IL
01
—
125.060396
STATE OF ILLINOIS DEPARTMENT OF FINANCIAL AND PROFESSIONAL REGULATION
IL
Enumeration date
03/29/2011
Last updated
08/29/2024
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