Velasco, Mario R
Velasco, Mario R is an individual health care provider with primary practice located at 210 W Mckinley Ave Suite 1, Decatur IL 62526. He recently has only one registered license in Allopathic & Osteopathic Physicians / Medical Oncology, which is considered as his primary health care specialty. Velasco, Mario R can be contacted via phone (217) 876-6600.Contact Information
Primary practice address
210 W Mckinley Ave Suite 1
Decatur IL 62526
Phone: (217) 876-6600
Fax: (217) 876-6606
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Medical Oncology | 207RX0202X | 036104082 | Illinois |
Profile Details
| NPI number | 1326007782 |
|---|---|
| LBN Legal business name | Velasco, Mario R |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Mar 22nd, 2006 |
| Last updated | Feb 12th, 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 | 1326007782 | NPPES |
| Illinois | MEDICAID | 036104082 |
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