Basic Information
| Provider Information | |||||||||
| NPI: | 1598487787 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | O'CONNOR | ||||||||
| FirstName: | DARRAGH | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2250 N ILLINOIS AVE | ||||||||
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| City: | CARBONDALE | ||||||||
| State: | IL | ||||||||
| PostalCode: | 629015612 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 900 N WASHINGTON ST | ||||||||
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| City: | DU QUOIN | ||||||||
| State: | IL | ||||||||
| PostalCode: | 628321233 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6185422146 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 09/14/2022 | ||||||||
| LastUpdateDate: | 09/14/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 09/14/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | 036.160615 | IL | Y | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.