Individual
TERRENCE A TYRRELL
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
180 SOUTH THIRD STREET, SUITE 101, BELLEVILLE, IL 62220
(618) 235-0651
(618) 235-9722
Mailing address
301 WEST LINCOLN STREET, SUITE 104, BELLEVILLE, IL 62220
(618) 235-0955
(618) 235-9203
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
R5620
MO
2085R0202X
Diagnostic Radiology Physician
Primary
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
141553
HEALTHLINK
—
01
—
L95010
MEDICARE PIN
—
Enumeration date
05/19/2006
Last updated
07/09/2007
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