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General NPI Number Information
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NPI Number | 1518129600
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Entity Type | Individual
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Provider Name | KELLI WEBB MD
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Gender | Female
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Dates
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Enumeration Date | 06/30/2008
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Last Update Date | 12/02/2021
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Provider Practice Location Address
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Address Line | 1400 FINANCIAL PARK DRIVE
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City | CARBONDALE
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State | IL
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Zip | 62901-0000
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Country | US
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Telephone | 618-351-9140
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Fax | 618-351-9143
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Provider Business Mailing Address
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Address Line | PO BOX 3988
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City | CARBONDALE
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State | IL
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Zip | 62902-3988
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Country | US
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Telephone | 618-457-5200
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Fax | 618-529-0586
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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 | 2086S0122X
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Taxonomy Name | Plastic and Reconstructive Surgery Physician
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License Number | 036135185
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License Number State | IL
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