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MT VERNON NEUROLOGY S.C. NPI 1720079015


NPI Information

NPI: 1720079015
Provider Name: MT VERNON NEUROLOGY, S.C.
Classification: Psychiatry & Neurology - 2084N0400X
Entity Type: Organization

Specialization: Neurology

Address:
2605 MAIN ST
MOUNT VERNON, IL
ZIP 62864
Phone: (618) 242-7350
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MT VERNON NEUROLOGY, S.C. is a neurology psychiatry neurology in Mount Vernon, IL. The provider is a Neurologist specializes in the diagnosis and treatment of diseases or impaired function of the brain, spinal cord, peripheral nerves, muscles, autonomic nervous system, and blood vessels that relate to these structures. MT VERNON NEUROLOGY, S.C. NPI is 1720079015. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

2605 MAIN ST
MOUNT VERNON, IL
ZIP 62864-372
Phone: (618) 242-7350
Fax: (618) 242-7351

The provider's authorized official is Tomasz A Kosierkiewicz .
The authorized official title is Md and has the following contact phone number (618) 242-7350.

The enumeration date for this NPI number is 11/4/2005 and was last updated on 7/17/2012.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
12084N0400XPsychiatry & NeurologyNeurologyYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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