Vandorn, Michelle M

Vandorn, Michelle M is an individual health care provider with primary practice located at 4315 Memorial Dr , Belleville IL 62226-5342. She recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Emergency Medicine, Allopathic & Osteopathic Physicians / Geriatric Medicine, Allopathic & Osteopathic Physicians / Internal Medicine. Allopathic & Osteopathic Physicians / Internal Medicine is her primary health care specialty. Vandorn, Michelle M can be contacted via phone (618) 257-6220.

Contact Information

Primary practice address
4315 Memorial Dr Belleville IL 62226-5342
Phone: (618) 257-6220
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Emergency Medicine 207P00000X 036-107561 Illinois
Allopathic & Osteopathic Physicians / Geriatric Medicine 207RG0300X 036107561 Illinois
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 036-107561 Illinois

Profile Details

NPI number 1093817355
LBN Legal business name Vandorn, Michelle M
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 5th, 2006
Last updated Jan 3rd, 2020 - about 5 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 1093817355 NPPES
Missouri MEDICAID 1093817355
Missouri MEDICAID 036107561

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