IDOL R MITCHELL DPM PC NPI 1003987173

NPI Information

  • NPI: 1003987173
  • Provider Name: IDOL R MITCHELL DPM PC
  • Classification: Podiatrist - 213E00000X
  • Entity Type: Organization
  • Address: 437 EAST GRANT STREET
    MACOMB, IL
    ZIP 61455
  • Phone: (309) 837-3964

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NPI Details

IDOL R MITCHELL DPM PC is a podiatrist in Macomb, IL. The provider is a podiatrist is a person qualified by a Doctor of Podiatric Medicine (D.P.M.) degree, licensed by the state, and practicing within the scope of that license. Podiatrists diagnose and treat foot diseases and deformities. They perform medical, surgical and other operative procedures, prescribe corrective devices and prescribe and administer drugs and physical therapy. IDOL R MITCHELL DPM PC NPI is 1003987173. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

437 EAST GRANT STREET
MACOMB, IL
ZIP 61455-352
Phone: (309) 837-3964
Fax: (309) 837-3966

The provider's authorized official is Idol R. Mitchell .
The authorized official title is President and has the following contact phone number (309) 836-7900.

The enumeration date for this NPI number is 11/12/2006 and was last updated on 6/30/2008.

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
1213E00000XPodiatrist016004683ILLINOISYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
14452210001OTHERDMERC
24452210001MEDICARE NSCILLINOIS
312170MEDICARE ID-TYPE UNSPECIFIEDIOWA
4214428OTHERILLINOISMEDICARE ID
5480034728OTHERRAILROAD MEDICARE
6U42201MEDICARE UPINILLINOIS
7016004683MEDICAIDILLINOIS
8K33206MEDICARE PINILLINOIS

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: 11/21/2025

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