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General NPI Number Information
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NPI Number | 1417974957
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Entity Type | Individual
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Provider Name | CAROL HURLEY M.D.
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Gender | Female
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Dates
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Enumeration Date | 07/17/2006
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Last Update Date | 03/01/2011
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Provider Practice Location Address
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Address Line | 1 MEMORIAL DR
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City | ALTON
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State | IL
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Zip | 62002-6722
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Country | US
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Telephone | 314-434-0600
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Fax |
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Provider Business Mailing Address
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Address Line | 75 REMIT DRIVE LOCKBOX 1876
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City | CHICAGO
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State | IL
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Zip | 60675-1876
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Country | US
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Telephone | 866-916-5259
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Fax | 231-922-4030
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 036-041772
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 30276
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License Number State | KY
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Taxonomy #3
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | R4135
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License Number State | MO
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