Healthcare Provider Details

I. General information

NPI: 1124722061
Provider Name (Legal Business Name): LEXI KREMER-CALLAHAN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/27/2023
Last Update Date: 09/17/2026
Certification Date: 09/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7342 STATE ROUTE 162
TROY IL
62294-3162
US

IV. Provider business mailing address

7342 STATE ROUTE 162
TROY IL
62294-3162
US

V. Phone/Fax

Practice location:
  • Phone: 618-343-3722
  • Fax:
Mailing address:
  • Phone: 618-343-3722
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number036177170
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: