Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Dr. Kevin M Ponciroli, MD

Individual provider Pediatrics Physician · NPI 1598776411

Dr. Kevin M Ponciroli, MD is a Pediatrics Physician in O Fallon, Illinois. Practices as a sole proprietor and works from 2 locations. Licensed in Illinois.

Licensed in
IL
In the registry since
2006
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

793 Sunset Blvd
O Fallon, IL 62269-1960
Phone: (618) 668-2473
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 914 Red Scarlet Ct, Shiloh, IL 62221-8306 — (618) 622-4955

Specialties & licences

Pediatrics Physician (primary) Taxonomy 208000000X · Licence 036115733 (IL)

Record details

NPI number1598776411
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorYes
NPI enumeratedAugust 10, 2006
Last updated in NPPESMarch 2, 2021
Certification dateMarch 2, 2021

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