Michael R. Mustard, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

036115033 Issued in IL

Practice address

1005 Broadway St
Quincy, IL 62301-2834

Phone

(217) 223-8400

Fax

(217) 214-5837

NPI assigned

Sep 28, 2006

Sex

Male

Sole proprietor

No

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Advocate Health and Hospitals Corporation

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• Carle West Physician Group Inc

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• Advocate Health and Hospitals Corporation

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• Carolinas Physicians Network Inc

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• Carolinas Physicians Network Inc

  • Endocrinology, Diabetes & Metabolism Physician
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• Carolinas Physicians Network Inc

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• Carolinas Physicians Network Inc

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  • Charlotte, NC
  • NPI 1497762686
  NPD (past) Family Medicine
• Carolinas Physicians Network Inc

  • Family Medicine Physician
  • Huntersville, NC
  • NPI 1508892746
  NPD (past) Family Medicine
• Carolinas Physicians Network Inc

  • Family Medicine Physician
  • Matthews, NC
  • NPI 1700079225
  NPD (past) Family Medicine
• Carolinas Physicians Network Inc

  • Family Medicine Physician
  • Concord, NC
  • NPI 1902049190
  NPD (past) Family Medicine
• Union Urgent Care LLC

  • Durable Medical Equipment & Medical Supplies
  • Monroe, NC
  • NPI 1063421469
  NPD (past) Family Medicine
• Union Urgent Care LLC

  • Family Medicine Physician
  • Indian Trail, NC
  • NPI 1659380079
  NPD (past) Family Medicine

Medicare fee-for-service enrollment

Enrolled in IL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Aug 6, 2025.

{
    "created_epoch": "1159401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754438400000",
    "number": "1295826675",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1005 BROADWAY ST",
            "city": "QUINCY",
            "state": "IL",
            "postal_code": "623012834",
            "telephone_number": "217-223-8400",
            "fax_number": "217-277-3960"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1005 BROADWAY ST",
            "city": "QUINCY",
            "state": "IL",
            "postal_code": "623012834",
            "telephone_number": "217-223-8400",
            "fax_number": "217-214-5837"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1437 E College Ave",
            "address_purpose": "LOCATION",
            "city": "Normal",
            "state": "IL",
            "postal_code": "617612085",
            "country_code": "US",
            "telephone_number": "309-454-4411",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MUSTARD",
        "first_name": "MICHAEL",
        "middle_name": "R.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-28",
        "last_updated": "2025-08-06",
        "certification_date": "2025-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NC",
            "license": "2009-00236",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MO",
            "license": "2009038317",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036115033",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5911855",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2009038317",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036115033",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Maha Mumtaz, MD
• Lori Ann Murphy
• Tracy Douglas Murphy, MD
• Carolyn Musholt, PT
• Adnan Mushtaq, M.D.
• Wayland J Mutter, RN
• Arshad R Muzaffar, MD
• Cheyenne Noelle Myers
• Kirsten V Myers Sr., PHARMD
• Michael G Myers, LPC

• All providers in Quincy, IL
• Family Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.