Mitchell, Jerry E

Mitchell, Jerry E is an individual health care provider with primary practice located at 3315 N Seminary St , Galesburg IL 61401-1251. He recently has only one registered license in Allopathic & Osteopathic Physicians / Surgery, which is considered as his primary health care specialty. Mitchell, Jerry E can be contacted via phone (309) 344-1000.

Contact Information

Primary practice address
3315 N Seminary St Galesburg IL 61401-1251
Phone: (309) 344-1000
Fax: (309) 344-1054
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Surgery 208600000X Illinois

Profile Details

NPI number 1679674402
LBN Legal business name Mitchell, Jerry E
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 26th, 2006
Last updated Jul 8th, 2007 - about 18 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 1679674402 NPPES
Other 10621858 CAQH
Other 4022647 CAQH
Other 364271985-38 CAQH
Other 4815127 CAQH

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