Sussman, Mitchell
Sussman, Mitchell is an individual health care provider with primary practice located at 611 W. Park St. Radiology, Urbana IL 61801. He recently has only one registered license in Allopathic & Osteopathic Physicians / Diagnostic Radiology, which is considered as his primary health care specialty. Sussman, Mitchell can be contacted via phone (217) 383-3270.Contact Information
Primary practice address
611 W. Park St. Radiology
Urbana IL 61801
Phone: (217) 383-3270
Fax: (217) 383-4116
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Diagnostic Radiology | 2085R0202X | 36088537 | Illinois |
| Allopathic & Osteopathic Physicians / Diagnostic Radiology | 2085R0202X | 036088537 | Illinois |
Profile Details
| NPI number | 1427097104 |
|---|---|
| LBN Legal business name | Sussman, Mitchell |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 6th, 2006 |
| Last updated | May 14th, 2014 - about 10 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 | 1427097104 | NPPES |
| Illinois | MEDICAID | 036088537*3 | |
| Illinois | Other | 0533210001 |
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