| Idol Ray Mitchell, DPM | |
|
437 East Grant Street, Macomb, IL 61455-3352 | |
| (309) 837-3964 | |
| (309) 837-3966 |
| Full Name | Idol Ray Mitchell |
|---|---|
| Gender | Male |
| Speciality | Podiatry |
| Experience | 33 Years |
| Location | 437 East Grant Street, Macomb, Illinois |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1508850694 | NPI | - | NPPES |
| 4452210001 | Other | DMERC | |
| 480034728 | Other | RAILROAD MEDICARE PROV # | |
| 016004683 | Medicaid | IL | |
| 214428 | Other | IL | MEDICARE ID |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 213E00000X | Podiatrist | 016-004683 (Illinois) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Mc Donough District Hospital | Macomb, IL | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Blessing Hospital | 3072422534 | 369 |
| Provider Name | Mcdonough County Hospital District |
|---|---|
| Provider Type | Part B Supplier - Clinic/group Practice |
| Provider Identifiers | NPI Number: 1669420766 PECOS PAC ID: 0446140180 Enrollment ID: O20040611000228 |
| Provider Name | Mcdonough County Hospital District |
|---|---|
| Provider Type | Part B Supplier - Clinic/group Practice |
| Provider Identifiers | NPI Number: 1609180082 PECOS PAC ID: 0446140180 Enrollment ID: O20090407000082 |
| Provider Name | Blessing Hospital |
|---|---|
| Provider Type | Part B Supplier - Hospital Department(s) |
| Provider Identifiers | NPI Number: 1114471737 PECOS PAC ID: 3072422534 Enrollment ID: O20161005001836 |
| Mailing Address | Practice Location Address |
|---|---|
| Idol Ray Mitchell, DPM 437 East Grant Street, Macomb, IL 61455-3352 Ph: (309) 837-3964 | Idol Ray Mitchell, DPM 437 East Grant Street, Macomb, IL 61455-3352 Ph: (309) 837-3964 |
Idol R Mitchell Dpm Pc Podiatrist Medicare: Not Enrolled in Medicare Practice Location: 437 East Grant Street, Macomb, IL 61455 Phone: 309-837-3964 Fax: 309-837-3966 | |
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 | |
Mcdonough County Hospital District Podiatrist Medicare: Not Enrolled in Medicare Practice Location: 437 E Grant St, Macomb, IL 61455 Phone: 309-837-3964 |