Individual
MADELYNN ANN KALLEMBACH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
604 ADAMS ST, MONTICELLO, IL 61856-2202
(217) 649-1663
Mailing address
604 ADAMS ST, MONTICELLO, IL 61856-2202
(217) 649-1663
Taxonomy
Speciality
Code
Description
License number
State
2083S0010X
Sports Medicine (Preventive Medicine) Physician
Primary
2000051152
KY
Other
Enumeration date
05/24/2022
Last updated
06/06/2022
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