Individual
DOLORES M CANTRELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
220 E HIGHWAY 40, TROY, IL 62294-2201
(618) 667-1200
(618) 667-4527
Mailing address
220 E HIGHWAY 40, TROY, IL 62294-2201
(618) 667-1200
(618) 667-4527
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
036073393
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036073393
—
IL
Enumeration date
06/14/2006
Last updated
12/11/2013
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