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Individual

CYNTHIA MARIE EMILY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA

Contact information

Practice address
211 S 3RD ST, BELLEVILLE, IL 62220-1915
(618) 234-2120
(618) 641-5806
Mailing address
211 S 3RD ST, BELLEVILLE, IL 62220-1915
(618) 234-2120
(618) 641-5806

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
2009020443
MO
363A00000X
Physician Assistant
Primary
085003840
IL

Other

Enumeration date
08/12/2008
Last updated
06/10/2011
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