Search › Illinois › 208000000X
Kevin Ponciroli, M.D
NPI 1598776411 · on the registry since 2006 · sole proprietor
Practice
- Address
- 793 Sunset Blvd
O Fallon, IL 62269 - Phone
- (618) 668-2473
- Organisation at this address
- Redbird Pediatrics, Pllc
Inferred from a shared address, not stated in the registry.
Additional practice sites
- 914 Red Scarlet Ct, Shiloh, IL
Registry record
- Primary taxonomy
- 208000000X
208000000X
- Licence states on file
- IL
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2021-03-02
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