MR. MARIO DONALD HODGE (NPI# 1023369501) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1023369501 |
| Entity Type | Individual |
| Full Name | MR. MARIO DONALD HODGE |
| Credential | C.PED |
| Practice Address |
1024 Jordan St Mount Vernon IL 62864-4231 |
| Practice Telephone | 6182424442 |
| Practice Fax Number | 6182423942 |
| Mailing Telephone | 6182424442 |
| Mailing Fax Number | 6182423942 |
| Enumeration Date | 2012-09-25 |
| Last Update Date | 2012-09-25 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 224L00000X | Pedorthist | 212.000161 | IL | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Street Address |
1024 JORDAN ST |
| City | MOUNT VERNON |
| State | IL |
| Zip Code | 62864-4231 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194078816 | Vivian L Martin | Prosthetic/Orthotic Supplier | 1024 Jordan St, Mount Vernon, IL 62864-4231 | 2012-10-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619438892 | Melissa Pryer | Dietitian, Registered | 2020 Broadway, Suite 1, Mt. Vernon, IL 62864 | 2019-03-28 |
| 1487145454 | Chiropractic Wellness Center of Mt Vernon, LLC. | Chiropractor | 1009 S 42nd St Ste 5, Mount Vernon, IL 62864 | 2018-05-24 |
| 1851889208 | Kimberly Tate | Counselor | 4110 North Water Place, Mt. Vernon, IL 62864 | 2018-05-01 |
| 1871907790 | University Hematology Oncology Inc | Specialist | #11 Cusumano Professional Plaza, Mount Vernon, IL 62864 | 2014-06-18 |
| 1457771677 | Dynamic Counseling and Consultation Services | Social Worker | 3600 S Water Tower Pl, Mt Vernon, IL 62864 | 2014-04-27 |
| 1619239431 | Judith C Morgan | Counselor | 16338 N Illinois Hwy 37, Mount Vernon, IL 62864 | 2012-06-08 |
| 1073888624 | James Brian Verges | Counselor | 16338 N. Illinois Hwy 37, Mount Vernon, IL 62864 | 2012-03-15 |
| 1720352271 | Lucinda M. Holdren | Counselor | 16338 North Illinois Highway 37, Mount Vernon, IL 62864 | 2012-03-01 |
| 1780978627 | Jamie M Orange | Physical Therapy Assistant | 19958 Fairfield Rd, Mt. Vernon, IL 62864 | 2011-06-08 |
| 1780978791 | Wendy Marie Claytor | Speech-Language Pathologist | 600 E Il Hwy 15, Mount Vernon, IL 62864 | 2011-06-07 |
| Find all providers in zip 62864 | ||||
| Taxonomy Code | 224L00000X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Pedorthist |
| An individual who is trained in the management and treatment of conditions of the foot, ankle, and lower extremities requiring fitting, fabricating, and adjusting of pedorthic devices. |
| Notes: Source: National Uniform Claim Committee [7/1/2010: new] Additional Resources: American Board for Certification in Orthotics, Prosthetics and Pedorthics, Inc., www.abcop.org and Board of Certification/Accreditation, International, www.bocusa.org. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962979534 | William Rooney | Pedorthist | 121 E Roosevelt Rd Ste B, Lombard, IL 60148-4561 | 2018-10-31 |
| 1386139145 | Edgar Alexander Barrios | Pedorthist | 307 W Saint Paul St, Spring Valley, IL 61362-1860 | 2018-06-25 |
| 1588168439 | Deborah Marie Adolfino | Pedorthist | 1s376 Summit Ave., Ct. E, Oakbrook Terrace, IL 60181 | 2018-03-23 |
| 1093217036 | Arnold Arellano | Pedorthist | 5202 Old Orchard Road, N100, Skokie, IL 60077 | 2018-03-06 |
| 1073015269 | Michael Martin Fishkin | Pedorthist | 508 Abbeywood Dr, Cary, IL 60013-2470 | 2018-03-02 |
| 1780185694 | Robin Spencer | Pedorthist | 1710 E Woodfield Rd Ste 555, Schaumburg, IL 60173-5153 | 2018-02-26 |
| 1225531494 | Evelyn A Ventrice | Pedorthist | 1551 Bond St Ste 111, Naperville, IL 60563-0150 | 2018-03-14 |
| 1992217129 | Jason Bergmann | Pedorthist | 1864 Johns Dr, Glenview, IL 60025-1657 | 2017-10-27 |
| City | MOUNT VERNON |
| Zip Code | 62864 |
Please comment or provide details below to improve the information on MR. MARIO DONALD HODGE.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.