Allen, Mary Ellen
Allen, Mary Ellen is an individual health care provider with primary practice located at 222 N Sangamon Ave , Gibson City IL 60936. She recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as her primary health care specialty. Allen, Mary Ellen can be contacted via phone (217) 748-8148.Contact Information
Primary practice address
222 N Sangamon Ave
Gibson City IL 60936
Phone: (217) 748-8148
Fax: (217) 784-8160
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 209001628 | Illinois |
Profile Details
NPI number | 1114931623 |
---|---|
LBN Legal business name | Allen, Mary Ellen |
Credentials | Advanced Practice Nurse (APN) |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | Jul 28th, 2006 |
Last updated | Feb 27th, 2024 - about 9 months 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 | 1114931623 | NPPES |
Illinois | MEDICAID | 362658552001 |
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