Search › Illinois › 122300000X
Michael Connolly
NPI 1487921490 · on the registry since 2011
Practice
- Address
- 1001 Illini Dr
East Peoria, IL 61611 - Phone
- (309) 694-2620
- Organisation at this address
- Maple Shade Dental (East Peoria) Llc
Inferred from a shared address, not stated in the registry.
- Clinicians at this address
- 3
Registry record
- Primary taxonomy
- 122300000X
122300000X
- Licence states on file
- IL
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2011-11-18
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Illinois