Individual
CANDYCE FREY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4414 W CENTER DR, ALTON, IL 62002-5932
(618) 628-8211
(618) 628-0883
Mailing address
916 TALON DR, O FALLON, IL 62269-1848
(618) 628-8211
(618) 628-0883
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
209.031860
IL
363L00000X
Nurse Practitioner
Primary
209.031860
IL
Other
Enumeration date
03/17/2025
Last updated
04/15/2025
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