Mundt, John Edward

Mundt, John Edward is an sole proprietor health care provider with primary practice located at 1523 William St , River Forest IL 60305-1138. He recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as his primary health care specialty. Mundt, John Edward can be contacted via phone (312) 608-0668.

Contact Information

Primary practice address
1523 William St River Forest IL 60305-1138
Phone: (312) 608-0668
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 103TC0700X Illinois

Profile Details

NPI number 1710998596
LBN Legal business name Mundt, John Edward
Credentials PH.D.
Entity Individual
Sole proprietor 1 Yes
Enumeration date Aug 10th, 2006
Last updated Jul 8th, 2007 - 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 1710998596 NPPES
Illinois Other 0051648579 BLUE CROSS BLUE SHIELD

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