Mt Vernon Neurology, S.C.

Primary specialty

Neurology PhysicianTaxonomy code 2084N0400X

Legal business name

MT VERNON NEUROLOGY, S.C.

Practice address

2605 Main St
Mount Vernon, IL 62864-2372

Phone

(618) 242-7350

Fax

(618) 242-7351

NPI assigned

Nov 4, 2005

Organization subpart

No

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

Authorized official

Name

Tomasz A Kosierkiewicz, MDNPI 1487645776

Title

MD

Phone

(618) 242-7350

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Tomasz A Kosierkiewicz X, MD

  • Neurology Physician
  • Mount Vernon, IL
  • NPI 1487645776
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1131062400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1342483200000",
    "number": "1720079015",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2277",
            "city": "MOUNT VERNON",
            "state": "IL",
            "postal_code": "628640044",
            "telephone_number": "618-242-7350",
            "fax_number": "618-242-7351"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2605 MAIN ST",
            "city": "MOUNT VERNON",
            "state": "IL",
            "postal_code": "628642372",
            "telephone_number": "618-242-7350",
            "fax_number": "618-242-7351"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MT VERNON NEUROLOGY, S.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-04",
        "last_updated": "2012-07-17",
        "status": "A",
        "authorized_official_last_name": "KOSIERKIEWICZ",
        "authorized_official_first_name": "TOMASZ",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "MD",
        "authorized_official_telephone_number": "618-242-7350",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kelli Mowrer, CNP
• Mt Vernon Community Pharmacy Inc
• Mt Vernon Community Pharmacy Inc
• Mt Vernon Cty SCH Dist 80
• Mt Vernon Family Practice PC
• Mt Vernon Radiation Therapy Center
• Mt Vernon Spine and Disc Center, LLC
• Mt Vernon TWP HS Dist 201
• Mt. Vernon Chiropractic Clinic, PLLC
• Mt. Vernon Eye Clinic, PLLC

• Neurology Physician in Mount Vernon, IL
• Providers in Mount Vernon, IL by specialty
• Neurology Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.