# MAIN STREET MEDICAL GROUP LLC, O Fallon IL: General Practice (NPI 1043832769)

**Practice Launch & Vendor Spend Score:** 25/100

| Field | Value |
|---|---|
| NPI | 1043832769 |
| Practice | MAIN STREET MEDICAL GROUP LLC |
| Specialty (taxonomy) | General Practice |
| Address | 124 Regency Park Ste 7 |
| City | O Fallon |
| State | IL |
| ZIP | 62269 |
| Practice phone | 480-926-2260 |
| Authorized official | ELLIE DESCALZO |
| Official title | Credentialing Officer |
| Enumerated | 2020-05-15 |
| Last updated | 2021-05-04 |
| Status | Active |

## Why this score
- Established practice (enumerated 2020-05-15).
- Practice phone listed.

Source: CMS NPPES NPI Registry (U.S. Centers for Medicare & Medicaid Services) (https://npiregistry.cms.hhs.gov/provider-view/1043832769). Last refreshed: 2026-11-03T01:38:44.844Z.
Data from the public CMS NPPES NPI Registry, which practices maintain themselves and may be out of date. Informational only; respect do-not-call and anti-spam laws when contacting practices.