Individual
EDWARD A CONNOLLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
520 VALLEY VIEW DR, MOLINE, IL 61265-6194
(309) 762-3621
(309) 762-3690
Mailing address
520 VALLEY VIEW DR, MOLINE, IL 61265-6194
(309) 762-3621
(309) 762-3690
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
036093095
IL
207X00000X
Orthopaedic Surgery Physician
28464
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
028389
HEALTH ALLIANCE
—
05
—
036093095
—
IL
01
—
05353
WELLMARK
—
01
—
18604
MIDLANDS CHOICE
—
05
—
1917237
—
IA
01
—
200029113
RR MEDICARE
—
01
—
20170
IA HEALTH SOLUTIONS
—
01
—
8121085
BCBS
IL
01
—
99717
WELLMARK
—
01
—
99728
WELLMARK
—
01
—
IA0194
JOHN DEERE FAMILY
—
01
—
IL0174
JOHN DEERE FAMILY
—
Enumeration date
01/04/2006
Last updated
03/18/2011
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