| Idol R Mitchell Dpm Pc | |
|
437 East Grant Street, Macomb, IL 61455-3352 | |
| (309) 837-3964 | |
| (309) 837-3966 |
| Full Name | Idol R Mitchell Dpm Pc |
|---|---|
| Type | Facility |
| Speciality | Podiatrist |
| Location | 437 East Grant Street, Macomb, Illinois |
| Accepts Medicare Assignments | Does not participate in Medicare Program. The facility may not accept medicare assignment. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1003987173 | NPI | - | NPPES |
| 016004683 | Medicaid | IL | |
| 480034728 | Other | RAILROAD MEDICARE | |
| 4452210001 | Other | DMERC | |
| 214428 | Other | IL | MEDICARE ID |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 213E00000X | Podiatrist | 016004683 (Illinois) | Primary |
| Mailing Address | Practice Location Address |
|---|---|
| Idol R Mitchell Dpm Pc 437 East Grant Street, Macomb, IL 61455-3352 Ph: (309) 837-3964 | Idol R Mitchell Dpm Pc 437 East Grant Street, Macomb, IL 61455-3352 Ph: (309) 837-3964 |
Dr. Max Ronald Rexroat, DPM Podiatrist Medicare: Not Enrolled in Medicare Practice Location: 437 E Grant St, Macomb, IL 61455 Phone: 309-837-3964 Fax: 309-837-3966 | |
Max R Rexroat, Dpm, Ltd Podiatrist Medicare: Not Enrolled in Medicare Practice Location: 437 E Grant St, Macomb, IL 61455 Phone: 309-837-3964 | |
Idol Ray Mitchell, DPM Podiatrist Medicare: Accepting Medicare Assignments Practice Location: 437 East Grant Street, Macomb, IL 61455 Phone: 309-837-3964 Fax: 309-837-3966 | |
Mdh Foot And Ankle Clinic Podiatrist Medicare: Not Enrolled in Medicare Practice Location: 437 E Grant St, Macomb, IL 61455 Phone: 309-837-3964 |