Iacob, Mircea Tudor

Iacob, Mircea Tudor is an individual health care provider with primary practice located at 25 N Winfield Rd , Winfield IL 60190-1295. He recently has 3 registered licenses in different health care specialties including Other Service Providers / Specialist, Allopathic & Osteopathic Physicians / Neurology, Allopathic & Osteopathic Physicians / Vascular Neurology. Allopathic & Osteopathic Physicians / Vascular Neurology is his primary health care specialty. Iacob, Mircea Tudor can be contacted via phone (630) 933-4056.

Contact Information

Primary practice address
25 N Winfield Rd Winfield IL 60190-1295
Phone: (630) 933-4056
Fax: (630) 933-4057
Website:
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Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Specialist 174400000X 036-113093 Illinois
Allopathic & Osteopathic Physicians / Neurology 2084N0400X 036113093 Illinois
Allopathic & Osteopathic Physicians / Vascular Neurology 2084V0102X 036113093 Illinois

Profile Details

NPI number 1588617856
LBN Legal business name Iacob, Mircea Tudor
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 18th, 2006
Last updated Dec 3rd, 2012 - about 12 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 1588617856 NPPES
Illinois Other 1635130 BCBS
Illinois Other P01090248 BCBS
Illinois Other 206147084 BCBS
Illinois MEDICAID 036113093 BCBS
Illinois Other CE8792 BCBS

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