Modert, Sara Kneedler
Modert, Sara Kneedler is an individual health care provider with primary practice located at 1 Doctors Park Rd Ste C , Mount Vernon IL 62864. She recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as her primary health care specialty. Modert, Sara Kneedler can be contacted via phone (618) 244-1234.Contact Information
Primary practice address
1 Doctors Park Rd Ste C
Mount Vernon IL 62864
Phone: (618) 244-1234
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 036079217 | Illinois |
Profile Details
| NPI number | 1700866258 |
|---|---|
| LBN Legal business name | Modert, Sara Kneedler |
| Credentials | Doctor of Osteopathy (DO) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jan 19th, 2006 |
| Last updated | Nov 4th, 2020 - about 5 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1700866258 | NPPES |
| Illinois | MEDICAID | 036079217 |
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