Mayberry, Kohl Mitchell

Mayberry, Kohl Mitchell is an sole proprietor health care provider with primary practice located at 1335 N Mill St Ste 100 , Naperville IL 60563-2047. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Psychiatry, Allopathic & Osteopathic Physicians / Child & Adolescent Psychiatry. Allopathic & Osteopathic Physicians / Child & Adolescent Psychiatry is his primary health care specialty. Mayberry, Kohl Mitchell can be contacted via phone (630) 305-5027.

Contact Information

Primary practice address
1335 N Mill St Ste 100 Naperville IL 60563-2047
Phone: (630) 305-5027
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Psychiatry 2084P0800X 036.156105 Illinois
Allopathic & Osteopathic Physicians / Child & Adolescent Psychiatry 2084P0804X 036156105 Illinois

Profile Details

NPI number 1295028256
LBN Legal business name Mayberry, Kohl Mitchell
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 Yes
Enumeration date May 24th, 2011
Last updated Dec 5th, 2023 - about last year

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 1295028256 NPPES
Florida MEDICAID 007622900

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