Vandorn, Michelle M
Vandorn, Michelle M is an individual health care provider with primary practice located at 4315 Memorial Dr , Belleville IL 62226-5342. She recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Emergency Medicine, Allopathic & Osteopathic Physicians / Geriatric Medicine, Allopathic & Osteopathic Physicians / Internal Medicine. Allopathic & Osteopathic Physicians / Internal Medicine is her primary health care specialty. Vandorn, Michelle M can be contacted via phone (618) 257-6220.Contact Information
Primary practice address
4315 Memorial Dr
Belleville IL 62226-5342
Phone: (618) 257-6220
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Emergency Medicine | 207P00000X | 036-107561 | Illinois |
| Allopathic & Osteopathic Physicians / Geriatric Medicine | 207RG0300X | 036107561 | Illinois |
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | 036-107561 | Illinois |
Profile Details
| NPI number | 1093817355 |
|---|---|
| LBN Legal business name | Vandorn, Michelle M |
| Credentials | Doctor of Osteopathy (DO) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Sep 5th, 2006 |
| Last updated | Jan 3rd, 2020 - about 6 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 | 1093817355 | NPPES |
| Missouri | MEDICAID | 1093817355 | |
| Missouri | MEDICAID | 036107561 |
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