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:
Health care specialties
| Specialty | Code | License # | 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 13 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 | 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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