Loret De Mola, Julio R

Loret De Mola, Julio R is an individual health care provider with primary practice located at 751 N Rutledge St Suite 0100, Springfield IL 62702-4968. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Obstetrics & Gynecology, Allopathic & Osteopathic Physicians / Reproductive Endocrinology. Allopathic & Osteopathic Physicians / Reproductive Endocrinology is his primary health care specialty. Loret De Mola, Julio R can be contacted via phone (217) 545-8000.

Contact Information

Primary practice address
751 N Rutledge St Suite 0100 Springfield IL 62702-4968
Phone: (217) 545-8000
Fax: (217) 545-3119
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Obstetrics & Gynecology 207V00000X 036-118863 Illinois
Allopathic & Osteopathic Physicians / Reproductive Endocrinology 207VE0102X 036-118863 Illinois

Profile Details

NPI number 1326071887
LBN Legal business name Loret De Mola, Julio R
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 8th, 2006
Last updated Oct 22nd, 2020 - about 4 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 1326071887 NPPES
Illinois MEDICAID 036118863

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