Mitra, Prodyot Kumar

Mitra, Prodyot Kumar is an individual health care provider with primary practice located at 633 Ridgeview Drive , Mchenry IL 60050-7012. He recently has only one registered license in Allopathic & Osteopathic Physicians / Surgery, which is considered as his primary health care specialty. Mitra, Prodyot Kumar can be contacted via phone (815) 344-0621.

Contact Information

Primary practice address
633 Ridgeview Drive Mchenry IL 60050-7012
Phone: (815) 344-0621
Fax: (815) 344-0664
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Surgery 208600000X 036052608 Illinois

Profile Details

NPI number 1699841247
LBN Legal business name Mitra, Prodyot Kumar
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 27th, 2006
Last updated May 8th, 2008 - about 17 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 1699841247 NPPES
Illinois Other 024000852 RAILROAD MEDICARE
Illinois Other 05600205 RAILROAD MEDICARE
Illinois Other 5432896 RAILROAD MEDICARE
Illinois MEDICAID 0360526081 RAILROAD MEDICARE

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