John E Lovell, MD

Individual provider Active NPI Family Medicine Physician · Tremont, IL

NPI 1366442881 · NPPES record last updated May 15, 2008

Key facts

NPI
1366442881
Entity type
Individual (NPI type 1)
Primary specialty
Family Medicine Physician 207Q00000X
License
036055259 (IL)
Practice address
105 S Locust St
Tremont, IL 61568-0187
Phone
(309) 925-2961
Fax
(309) 925-4221
NPI assigned
Jul 27, 2005
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
036055259ILMDFamily Medicine Physician

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 036055259 IL Yes

Addresses

Primary practice location

105 S Locust St
Tremont, IL 61568-0187

Mailing address

105 S Locust St
PO Box 187
Tremont, IL 61568-0187
Phone (309) 925-2961

Other identifiers

IdentifierTypeStateIssuer
0901565684OtherILBCBS
036055259MedicaidIL
080031011OtherILRAILROAD MEDICARE

Other providers in Tremont, IL

All providers in Tremont, IL · Family Medicine Physician in Illinois

Sources for this page

Verify at the official NPI Registry.