Healthcare Provider Details

I. General information

NPI: 1003756461
Provider Name (Legal Business Name): MARA GRACE DOWNING MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MARA GRACE KELLER

II. Dates (important events)

Enumeration Date: 03/28/2026
Last Update Date: 03/28/2026
Certification Date: 03/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3 SAINT ELIZABETH BLVD STE 4000
O FALLON IL
62269-1284
US

IV. Provider business mailing address

3 SAINT ELIZABETH BLVD STE 4000
O FALLON IL
62269-1284
US

V. Phone/Fax

Practice location:
  • Phone: 618-233-5480
  • Fax: 184-445-8791
Mailing address:
  • Phone: 618-233-5480
  • Fax: 184-445-8791

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: