Active NPI
Mark M Allendorph, M.D.
- Gastroenterology Physician
- Alton, IL
National Provider Identifier
1922094002
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Gastroenterology Physician
- License
- 036072597
- Practice address
- 2 Memorial Dr
Suite 205
Alton, IL 62002-6723 - Phone
- (618) 465-5849
- Fax
- (618) 465-5853
- NPI assigned
- Sep 23, 2005
- 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 |
|---|---|---|---|---|
| Gastroenterology Physician | 207RG0100X | 036072597 | IL | Primary |
Addresses
Primary practice location
2 Memorial Dr
Suite 205
Alton, IL 62002-6723
Mailing address
2 Memorial Dr
Suite 205
Alton, IL 62002-6723
Phone (618) 465-5849
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": "1127433600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1211846400000",
"number": "1922094002",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2 MEMORIAL DR",
"address_2": "SUITE 205",
"city": "ALTON",
"state": "IL",
"postal_code": "620026723",
"telephone_number": "618-465-5849",
"fax_number": "618-465-5853"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2 MEMORIAL DR",
"address_2": "SUITE 205",
"city": "ALTON",
"state": "IL",
"postal_code": "620026723",
"telephone_number": "618-465-5849",
"fax_number": "618-465-5853"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ALLENDORPH",
"first_name": "MARK",
"middle_name": "M",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2005-09-23",
"last_updated": "2008-05-27",
"status": "A"
},
"taxonomies": [
{
"code": "207RG0100X",
"taxonomy_group": "",
"desc": "Internal Medicine, Gastroenterology",
"state": "IL",
"license": "036072597",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Alton, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.