NPI 1003987173

Idol R Mitchell DPM PC

Organisation Podiatrist Macomb, IL

Practice location

Address: 437 East Grant Street, Macomb, IL 61455-3352
Phone: (309) 837-3964
Fax: (309) 837-3966

Authorised official

Name: Idol R. Mitchell
Title: President
Phone: (309) 836-7900

Registered specialties

Podiatrist Primary

Podiatric Medicine & Surgery Service Providers Taxonomy 213E00000X Licence 016004683 (IL)

Other Podiatrist providers in Illinois →

Registry record

NPI: 1003987173
Entity type: Organization
NPI issued: 12 Nov 2006
Record last updated: 30 Jun 2008

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.