Dr Brock B Mullenbach, DO is a medicare enrolled "Physical Medicine & Rehabilitation - Sports Medicine" physician in Bourbonnais, Illinois. His current practice location is
6712 N Convent St, Bourbonnais, Illinois. You can reach out to his office (for appointments etc.) via phone at
(815) 605-8403.
Dr Brock B Mullenbach is licensed to practice in Illinois (license number 036.164439) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1841750924.
Physician's Profile
Full Name | Dr Brock B Mullenbach |
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Gender | Male |
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Speciality | Physical Medicine & Rehabilitation - Sports Medicine |
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Location | 6712 N Convent St, Bourbonnais, Illinois |
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Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1841750924
- Provider Enumeration Date: 03/23/2019
- Last Update Date: 07/09/2024
Medicare PECOS Information:
- PECOS PAC ID: 3678996766
- Enrollment ID: I20240815002231
Medical Identifiers
Medical identifiers for Dr Brock B Mullenbach such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1841750924 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
208100000X | Physical Medicine & Rehabilitation | 036.164439 (Illinois) | Secondary |
2081S0010X | Physical Medicine & Rehabilitation - Sports Medicine | 036.164439 (Illinois) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Dr Brock B Mullenbach allows following entities to bill medicare on his behalf.
Entity Name | Illinois Bone And Joint Institute Llc |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1205922432 PECOS PAC ID: 6002814878 Enrollment ID: O20061110000331 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Brock B Mullenbach is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Dr Brock B Mullenbach, DO 6712 N Convent St, Bourbonnais, IL 60914-1528 Ph: (815) 605-8403 | Dr Brock B Mullenbach, DO 6712 N Convent St, Bourbonnais, IL 60914-1528 Ph: (815) 605-8403 |
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