Active NPI
Dennis Paul Mlot, M.D.
- Otolaryngic Allergy Physician
- Mount Vernon, IL
National Provider Identifier
1609955715
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Otolaryngic Allergy Physician
- License
- 036105686
- Practice address
- 2413 Broadway St
Mount Vernon, IL 62864-2917 - Phone
- (618) 244-6559
- NPI assigned
- Nov 2, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Otolaryngic Allergy Physician | 207YX0602X | 036105686 | IL | Primary |
Addresses
Primary practice location
2413 Broadway St
Mount Vernon, IL 62864-2917
Mailing address
2413 Broadway St
Mount Vernon, IL 62864-2917
Phone (618) 244-6559
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 036105686 | Medicaid | IL | |
| 04132003 | Other | IL | BCBS |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1162425600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1193184000000",
"number": "1609955715",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2413 BROADWAY ST",
"city": "MOUNT VERNON",
"state": "IL",
"postal_code": "628642917",
"telephone_number": "618-244-6559"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2413 BROADWAY ST",
"city": "MOUNT VERNON",
"state": "IL",
"postal_code": "628642917",
"telephone_number": "618-244-6559"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MLOT",
"first_name": "DENNIS",
"middle_name": "PAUL",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-11-02",
"last_updated": "2007-10-24",
"status": "A"
},
"taxonomies": [
{
"code": "207YX0602X",
"taxonomy_group": "",
"desc": "Otolaryngology, Otolaryngic Allergy",
"state": "IL",
"license": "036105686",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "036105686",
"state": "IL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "04132003",
"state": "IL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Mount Vernon, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.