Locke, Jonathan T
Locke, Jonathan T is an individual health care provider with primary practice located at 2300 N Edward St , Decatur IL 62526-4163. He recently has only one registered license in Allopathic & Osteopathic Physicians / Diagnostic Radiology, which is considered as his primary health care specialty. Locke, Jonathan T can be contacted via phone (217) 876-2300.Contact Information
Primary practice address
2300 N Edward St
Decatur IL 62526-4163
Phone: (217) 876-2300
Fax: (217) 876-6725
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Diagnostic Radiology | 2085R0202X | 036085891 | Illinois |
Profile Details
| NPI number | 1982650990 |
|---|---|
| LBN Legal business name | Locke, Jonathan T |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 25th, 2006 |
| Last updated | Jun 6th, 2024 - about 5 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 | 1982650990 | NPPES |
| Illinois | MEDICAID | 036085891 |
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