NPIMap

Organization Active NPI

Midwest Ear Nose & Throat Clinic, S.C.

  • Otolaryngology Physician
  • Herrin, IL
National Provider Identifier
1477764942
Registry record updated Jan 22, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
Legal business name
MIDWEST EAR NOSE & THROAT CLINIC, S.C.
Practice address
3316 Patriot CT
Herrin, IL 62948-3782
Phone
(618) 993-0307
Fax
(618) 993-0807
NPI assigned
May 25, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 22, 2010

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
David Mann, M.D.NPI 1386739670
Title
Owner
Phone
(618) 993-0307

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Y00000X IL Primary

Addresses

Primary practice location

3316 Patriot CT
Herrin, IL 62948-3782

Mailing address

3316 Patriot CT
Herrin, IL 62948-3782
Phone (618) 993-0307

National Provider Directory

National Provider Directory

Locations

100 Hospital Dr
Harrisburg, IL 62946
Phone (618) 252-0999

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1180051200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1264118400000",
    "number": "1477764942",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3316 PATRIOT CT",
            "city": "HERRIN",
            "state": "IL",
            "postal_code": "629483782",
            "telephone_number": "618-993-0307",
            "fax_number": "618-993-0807"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3316 PATRIOT CT",
            "city": "HERRIN",
            "state": "IL",
            "postal_code": "629483782",
            "telephone_number": "618-993-0307",
            "fax_number": "618-993-0807"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIDWEST EAR NOSE & THROAT CLINIC, S.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-25",
        "last_updated": "2010-01-22",
        "status": "A",
        "authorized_official_last_name": "MANN",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "618-993-0307",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Otolaryngology",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Herrin, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.