Sakornbut, Ellen Louise
Sakornbut, Ellen Louise is an individual health care provider with primary practice located at 220 W Ridgeway Ave Suite 106, Waterloo IA 50701-4200. She recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as her primary health care specialty. Sakornbut, Ellen Louise can be contacted via phone (319) 226-4400.Contact Information
Primary practice address
220 W Ridgeway Ave Suite 106
Waterloo IA 50701-4200
Phone: (319) 226-4400
Fax: (319) 226-4401
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 34687 | Iowa |
Profile Details
| NPI number | 1578567947 |
|---|---|
| LBN Legal business name | Sakornbut, Ellen Louise |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 13th, 2005 |
| Last updated | Jul 9th, 2007 - about 19 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 | 1578567947 | NPPES |
| Iowa | MEDICAID | 1268821 | |
| Iowa | Other | 38764 |
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