| Mt Vernon Neurology, S.c. | |
|
2605 Main St Mount Vernon IL 62864-2372 | |
| (618) 242-7350 | |
| (618) 242-7351 |
| Full Name | Mt Vernon Neurology, S.c. |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 2605 Main St, Mount Vernon, Illinois |
| Authorized Official Name and Position | Tomasz A Kosierkiewicz (MD) |
| Authorized Official Contact | 6182427350 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mt Vernon Neurology, S.c. Po Box 2277 Mount Vernon IL 62864-0044 Ph: (618) 242-7350 | Mt Vernon Neurology, S.c. 2605 Main St Mount Vernon IL 62864-2372 Ph: (618) 242-7350 |
| NPI Number | 1720079015 |
|---|---|
| Provider Enumeration Date | 11/04/2005 |
| Last Update Date | 07/17/2012 |
| Medicare PECOS PAC ID | 0446416317 |
|---|---|
| Medicare Enrollment ID | O20120720000177 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1720079015 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0400X | Psychiatry & Neurology - Neurology | (* (Not Available)) | Primary |
| Provider Name | Tomasz A Kosierkiewicz |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1487645776 PECOS PAC ID: 2668638537 Enrollment ID: I20120720000576 |
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