Dr. Kevin M Ponciroli
M.D. | Pediatrics | Male
Dr. Kevin M Ponciroli, M.D. is a O Fallon, Illinois based Pediatric doctor with medical specialization in
General Pediatrics.
Current practice location of Dr. Kevin M Ponciroli is
793 Sunset Blvd, O Fallon, Illinois - 62269-1960. He can be contacted on phone at
618-668-2473.
Dr. Kevin M Ponciroli is a sole proprietor of his business.
NPI number (Unique professional ID) for Dr. Kevin M Ponciroli is
1598776411 which was assigned by NPPES on 10 Aug, 2006 and it was last updated on 02 Mar, 2021.
Dr. Kevin M Ponciroli license number is
036115733 for Pediatrics (208000000X) in Illinois.
Dr. Kevin M Ponciroli is a pediatrician who is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.
Complete Profile:
Dr. Kevin M Ponciroli basic information including his official name, gender, specialization, credentials etc. are as mentioned below.
| Specialization : | Pediatrics |
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| Provider Name : | Dr. Kevin M Ponciroli |
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| Credential : | M.D. |
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| Gender : | Male |
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| Sole Proprietor : | Yes |
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Business Address:
Dr. Kevin M Ponciroli address, contact phone number and fax are as below. Patients can directly walkin to the clinic or can call on the below given phone number for appointment.
| Primary Address : | 793 Sunset Blvd
O Fallon, IL, 62269-1960
United States |
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| Phone Number : | 618-668-2473 |
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Professional Identification Codes:
NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). NPI details are as mentioned below.
| NPI Number : | 1598776411 |
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| NPI Entity Type : | Individual |
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| First Enrolment Date : | 10 Aug, 2006 |
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| Last Updated On : | 02 Mar, 2021 |
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Licenses and Specialities:
Physicians/Organizations can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Dr. Kevin M Ponciroli are as mentioned. Primary taxonomy code for Dr. Kevin M Ponciroli, M.D. is
208000000X (Pediatrics).
| Taxonomy Code | Speciality | Primary | License No. | State |
|---|
| 208000000X | Pediatrics | Yes | 036115733 | IL |
Legacy Identifiers:
Other legacy medical identifiers of Dr. Kevin M Ponciroli such as Medicaid, Medicare PIN, NSC, UPIN etc. are mentioned below.
| Identifier | Identifier Type | State | Issuer |
|---|
| 036115733 | MEDICAID | IL | |
Other Practice Locations:
| Practice Address | City, State | Phone Number |
|---|
914 RED SCARLET CT,
SHILOH, IL, 62221-8306
United States | SHILOH, IL | 618-622-4955 |
Mailing Address:
Mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned business address only.
| Mailing Address : | 793 Sunset Blvd
O Fallon, IL, 62269-1960
United States |
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| Phone Number : | 618-668-2473 |
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Business Location:
Patients can refer following map for directions to
Dr. Kevin M Ponciroli practice address. Don't forget to take prior appointment before visiting.
** Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES.