Sakornbut, Ellen Louise

Sakornbut, Ellen Louise is an individual health care provider with primary practice located at 220 W Ridgeway Ave Suite 106, Waterloo IA 50701-4200. She recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as her primary health care specialty. Sakornbut, Ellen Louise can be contacted via phone (319) 226-4400.

Contact Information

Primary practice address
220 W Ridgeway Ave Suite 106 Waterloo IA 50701-4200
Phone: (319) 226-4400
Fax: (319) 226-4401
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 34687 Iowa

Profile Details

NPI number 1578567947
LBN Legal business name Sakornbut, Ellen Louise
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 13th, 2005
Last updated Jul 9th, 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 1578567947 NPPES
Iowa MEDICAID 1268821
Iowa Other 38764

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