Molis, Tina M
Molis, Tina M is an individual health care provider with primary practice located at 101 W University Ave , Champaign IL 61820-3909. She recently has only one registered license in Allopathic & Osteopathic Physicians / Diagnostic Radiology, which is considered as her primary health care specialty. Molis, Tina M can be contacted via phone (217) 366-1285.Contact Information
Primary practice address
101 W University Ave
Champaign IL 61820-3909
Phone: (217) 366-1285
Fax: (217) 366-6129
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Diagnostic Radiology | 2085R0202X | 036-122369 | Illinois |
Profile Details
| NPI number | 1336167287 |
|---|---|
| LBN Legal business name | Molis, Tina M |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 18th, 2006 |
| Last updated | Jan 6th, 2022 - about 4 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1336167287 | NPPES |
| Illinois | Other | 279500 | MEDICARE GROUP |
| Illinois | MEDICAID | 200520830A | MEDICARE GROUP |
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