Individual
ADAM CONNELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
28 CHICK ST STE 100, METROPOLIS, IL 62960-2467
(618) 524-8381
Mailing address
8810 CRESTVIEW DR, INDIANAPOLIS, IN 46240-1935
(618) 658-0639
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
036.152471
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11018956A
IN TEMPORARY MEDICAL PERMIT
IN
Enumeration date
03/28/2016
Last updated
08/08/2022
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