Elliott, Michael W

Elliott, Michael W is an sole proprietor health care provider with primary practice located at 807 W. Craft St. , Robinson IL 62454-1137. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Family Medicine, Ambulatory Health Care Facilities / Rural Health. Ambulatory Health Care Facilities / Rural Health is his primary health care specialty. Elliott, Michael W can be contacted via phone (618) 546-5052.

Contact Information

Primary practice address
807 W. Craft St. Robinson IL 62454-1137
Phone: (618) 546-5052
Fax: (618) 544-2094
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 036102103 Illinois
Ambulatory Health Care Facilities / Rural Health 261QR1300X 036-102103 Illinois

Profile Details

NPI number 1548267693
LBN Legal business name Elliott, Michael W
Credentials
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jul 5th, 2005
Last updated Oct 3rd, 2013 - about 13 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1548267693 NPPES
Illinois MEDICAID 036102103

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