Individual
MICHAEL EDWARD CONNOLLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
612 N 11TH ST, QUINCY, IL 62301-2662
(217) 224-9484
(217) 224-7950
Mailing address
612 N 11TH ST, QUINCY, IL 62301-2662
(217) 224-9484
(217) 224-7950
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
036-108107
IL
207Q00000X
Family Medicine Physician
34949
IA
207Q00000X
Family Medicine Physician
45217
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
34328300
—
WI
Enumeration date
05/12/2006
Last updated
01/09/2017
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