Mulligan, Michelle P

Mulligan, Michelle P is an individual health care provider with primary practice located at 3 Junction Dr W , Glen Carbon IL 62034-2916. She recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as her primary health care specialty. Mulligan, Michelle P can be contacted via phone (618) 288-5088.

Contact Information

Primary practice address
3 Junction Dr W Glen Carbon IL 62034-2916
Phone: (618) 288-5088
Fax: (618) 288-9153
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 036081019 Illinois

Profile Details

NPI number 1194721936
LBN Legal business name Mulligan, Michelle P
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 27th, 2005
Last updated Apr 30th, 2008 - about 16 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 1194721936 NPPES
Other 0107339 UNITED HEALTHCARE
Other 080021120 UNITED HEALTHCARE
Other 4622029 UNITED HEALTHCARE
MEDICAID 036081019 UNITED HEALTHCARE
Other 180420 UNITED HEALTHCARE
Other N8565 UNITED HEALTHCARE

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