Provider Demographics
NPI:1588978241
Name:TAILLEFER, MARGUERITE SIMONNE (MD)
Entity type:Individual
Prefix:DR
First Name:MARGUERITE
Middle Name:SIMONNE
Last Name:TAILLEFER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:MARGUERITE
Other - Middle Name:SIMONNE
Other - Last Name:TAILLEFER-JALIL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:225 S CONGRESS ST
Mailing Address - Street 2:
Mailing Address - City:RUSHVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:62681-1409
Mailing Address - Country:US
Mailing Address - Phone:217-322-3529
Mailing Address - Fax:217-322-2605
Practice Address - Street 1:225 S CONGRESS ST
Practice Address - Street 2:
Practice Address - City:RUSHVILLE
Practice Address - State:IL
Practice Address - Zip Code:62681-1409
Practice Address - Country:US
Practice Address - Phone:217-322-3529
Practice Address - Fax:217-322-2605
Is Sole Proprietor?:No
Enumeration Date:2010-08-04
Last Update Date:2011-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036-126812207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036-126812OtherFAMILY MEDICINE PHYSICIAN
CT150722OtherABFM