Simmons, Mary
Simmons, Mary is an individual health care provider with primary practice located at 1700 Henry Luckow Ln , Belvidere IL 61008. She recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as her primary health care specialty. Simmons, Mary can be contacted via phone (779) 696-8650.Contact Information
Primary practice address
1700 Henry Luckow Ln
Belvidere IL 61008
Phone: (779) 696-8650
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 036105006 | Illinois |
Profile Details
| NPI number | 1457373946 |
|---|---|
| LBN Legal business name | Simmons, Mary |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 24th, 2006 |
| Last updated | Feb 19th, 2021 - about 3 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 | 1457373946 | NPPES |
| Illinois | MEDICAID | 036105006 |
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