Individual
RECE PORTELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
3 SAINT ELIZABETH BLVD STE 1800, O FALLON, IL 62269-1281
(618) 233-6044
Mailing address
3 SAINT ELIZABETH BLVD STE 1800, O FALLON, IL 62269-1281
(618) 233-6044
(618) 233-5195
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
085011599
IL
Other
Enumeration date
05/14/2025
Last updated
09/02/2025
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