Individual
KEVIN CORRIGAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
103 N OAK ST, O FALLON, IL 62269-1165
(618) 624-3368
Mailing address
103 N OAK ST, O FALLON, IL 62269-1165
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
036-115262
IL
207P00000X
Emergency Medicine Physician
Primary
2007-00311
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
036-115262
LICENSE NUMBER
IL
Enumeration date
10/04/2006
Last updated
02/21/2025
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