Individual
KAREN LORDO SEGRIST
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1310 DADRIAN PROFESSIONAL PARK, GODFREY, IL 62035-1685
(618) 433-5005
(618) 467-1053
Mailing address
1310 DADRIAN PROFESSIONAL PARK, GODFREY, IL 62035-1685
(618) 433-5005
(618) 467-1053
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
036059505
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036059505
—
IL
01
—
P00072982
MEDICARE RR
IL
Enumeration date
12/29/2005
Last updated
06/04/2010
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