Victoria Lisa Codispoti, MD
Individual provider Active NPI Psychiatry Physician · Kell, IL
NPI 1710925367 · NPPES record last updated Mar 20, 2025
Key facts
- NPI
- 1710925367
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Psychiatry Physician 2084P0800X
- License
- 036108109 (IL)
- Practice address
- 4232 Cartter Rd
Kell, IL 62853-1148 - Phone
- (618) 292-3437
- Fax
- (618) 242-8240
- NPI assigned
- Jun 4, 2006
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Teladoc Health Medical Group, P.a. | Psychiatry | Current | Accepting new patients |
Interoperability endpoints
- victoriacodispoti@tdh.allscriptsdirect.net
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | 036108109 | IL | Yes |
Addresses
Primary practice location
4232 Cartter Rd
Kell, IL 62853-1148
Mailing address
4232 Cartter Rd
Kell, IL 62853-1148
Phone (618) 292-3437
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 036108109 | Medicaid | IL |
Other providers in Kell, IL
All providers in Kell, IL · Psychiatry Physician in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 20, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.