Addai, Theodore Rexford

Addai, Theodore Rexford is an individual health care provider with primary practice located at 1770 E Lake Shore Dr Ste 105 , Decatur IL 62521-3800. He recently has 2 registered licenses in different health care specialties including Other Service Providers / Specialist, Allopathic & Osteopathic Physicians / Cardiovascular Disease. Allopathic & Osteopathic Physicians / Cardiovascular Disease is his primary health care specialty. Addai, Theodore Rexford can be contacted via phone (217) 422-6100.

Contact Information

Primary practice address
1770 E Lake Shore Dr Ste 105 Decatur IL 62521-3800
Phone: (217) 422-6100
Fax: (833) 784-5326
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Specialist 174400000X 036078026 Illinois
Allopathic & Osteopathic Physicians / Cardiovascular Disease 207RC0000X 036078026 Illinois

Profile Details

NPI number 1912985185
LBN Legal business name Addai, Theodore Rexford
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 6th, 2006
Last updated Dec 20th, 2021 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1912985185 NPPES
Illinois Other 000334245 RAILROAD
Illinois MEDICAID 036078026 RAILROAD

Popular Providers