Porter, Myisha Z.
Porter, Myisha Z. is an individual health care provider with primary practice located at 1801 Windsor Rd , Champaign IL 61822-6217. She recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as her primary health care specialty. Porter, Myisha Z. can be contacted via phone (217) 366-1257.Contact Information
Primary practice address
1801 Windsor Rd
Champaign IL 61822-6217
Phone: (217) 366-1257
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | 036-119469 | Illinois |
Profile Details
| NPI number | 1093975443 |
|---|---|
| LBN Legal business name | Porter, Myisha Z. |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 10th, 2008 |
| Last updated | Mar 20th, 2024 - about last year |
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 | 1093975443 | NPPES |
| Illinois | MEDICAID | 1093975443 1 | |
| Illinois | Other | 279500 |
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