Healthcare Provider Details

I. General information

NPI: 1114414935
Provider Name (Legal Business Name): DANIELLE RAE HUGHES MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/17/2018
Last Update Date: 09/19/2025
Certification Date: 09/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4600 MEMORIAL DR STE 200
BELLEVILLE IL
62226-5363
US

IV. Provider business mailing address

PO BOX 7412011
CHICAGO IL
60674-2011
US

V. Phone/Fax

Practice location:
  • Phone: 618-233-2220
  • Fax:
Mailing address:
  • Phone: 800-862-9980
  • Fax: 314-362-1185

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207LC0200X
TaxonomyCritical Care Medicine (Anesthesiology) Physician
License Number036169358
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: