KENNETH JAMES MINIELLY

SPRINGFIELD, IL
NPI1699125062
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy207N00000X Dermatology
(Licence: IL  125-068691)
Enumeration Date2016-06-16
Last Update Date2016-06-16
Business Address
-- KENNETH JAMES MINIELLY M.D.
751 N RUTLEDGE ST STE 2300
SPRINGFIELD, IL 62702-4968
Phone number: 217-545-8000
Mailing Address
-- KENNETH JAMES MINIELLY M.D.
PO BOX 19644
SPRINGFIELD, IL 62794-9644
Phone number: 217-545-8000