Provider Demographics
NPI:1770977100
Name:JAMES, KRISTEN (MD)
Entity type:Individual
Prefix:
First Name:KRISTEN
Middle Name:
Last Name:JAMES
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2246 S STATE ROUTE 157 STE 100
Mailing Address - Street 2:
Mailing Address - City:GLEN CARBON
Mailing Address - State:IL
Mailing Address - Zip Code:62034-1717
Mailing Address - Country:US
Mailing Address - Phone:618-288-9251
Mailing Address - Fax:
Practice Address - Street 1:2246 S STATE ROUTE 157 STE 100
Practice Address - Street 2:
Practice Address - City:GLEN CARBON
Practice Address - State:IL
Practice Address - Zip Code:62034-1717
Practice Address - Country:US
Practice Address - Phone:618-288-9251
Practice Address - Fax:618-798-8129
Is Sole Proprietor?:No
Enumeration Date:2015-03-24
Last Update Date:2022-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036.150200207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology