RANDALL L MULLIN (NPI# 1174501332) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1174501332 |
| Entity Type | Individual |
| Full Name | RANDALL L MULLIN |
| Credential | MD |
| Practice Address |
110 S Depot St Annawan IL 61234-7768 |
| Practice Telephone | 3099445124 |
| Practice Fax Number | 3097211407 |
| Mailing Telephone | 3099445124 |
| Mailing Fax Number | 3097211407 |
| Enumeration Date | 2006-01-06 |
| Last Update Date | 2014-01-15 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | 036048491 | IL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | 1174501332 | 05 | |
| IL | 0360484912 | 05 | |
| IL | 036048491 | 05 |
| Street Address |
110 S DEPOT ST |
| City | ANNAWAN |
| State | IL |
| Zip Code | 61234-7768 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447289806 | Iowa Physicians Clinic Medical Foundation | Durable Medical Equipment & Medical Supplies | 110 S Depot St, Annawan, IL 61234-7768 | 2006-06-30 |
| 1093794745 | Paul M Rudy | Family Medicine | 110 S Depot St, Annawan, IL 61234-7768 | 2006-01-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407170798 | Kelli Rae Desplinter | Physical Therapy Assistant | 16142 E 2600 St, Annawan, IL 61234 | 2010-03-16 |
| 1619473204 | Jason Wilfred David | Student in an Organized Health Care Education/Training Program | 104 N Meadow Ln, Annawan, IL 61234-7603 | 2018-04-02 |
| 1306119953 | Annawan-alba Fire Protection District | Ambulance | 101 S Main St, Annawan, IL 61234-7704 | 2012-02-13 |
| 1114582913 | Hammond Henry Dist Hospital | Clinic/Center | 203 W Front St, Annawan, IL 61234-7756 | 2019-05-07 |
| 1093917551 | Annawan Community Unit 226 | Local Education Agency (LEA) | 501 W South St, Annawan, IL 61234-9715 | 2007-06-05 |
| 1598197105 | Countrywide Smiles P.C. | Dentist | 110 S State St, Annawan, IL 61234-9716 | 2013-08-06 |
| 1487092714 | Rima Mounsef | Dentist | 110 S State St, Annawan, IL 61234-9716 | 2013-06-09 |
| 1407859283 | Thomas Joseph Van Vooren | Dentist | 110 S State St, Annawan, IL 61234-9716 | 2005-05-24 |
| 1194882118 | Jeffrey Lynn Lathrop | Chiropractor | 219 N Canal St, Annawan, IL 61234-9765 | 2007-01-02 |
| 1720569023 | Lori Anderson | Specialist/Technologist | 410 S East St, Annawan, IL 61234-9771 | 2018-08-24 |
| Find all providers in zip 61234 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093794745 | Paul M Rudy | Family Medicine | 110 S Depot St, Annawan, IL 61234-7768 | 2006-01-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053911495 | Moataz Barkat | Family Medicine | 3315 W 66th Pl, Chicago, IL 60629-3427 | 2020-10-26 |
| 1558969964 | Nicole Kerner | Family Medicine | 310 Brandy Dr, Mackinaw, IL 61755-9707 | 2020-10-16 |
| 1285232991 | Healthy Medical Inc | Family Medicine | 535 N. East St., Suite A, Bradley, IL 60915 | 2020-10-14 |
| 1558976589 | Jasmine Ashley Fowler | Family Medicine | 2416 N Lotus Ave, Chicago, IL 60639-1435 | 2020-09-15 |
| 1790390805 | Kimberly Hannah Kupferberg | Family Medicine | 1103 Schaeffer Rd, Long Grove, IL 60047-5153 | 2020-09-15 |
| 1194330977 | Home Doctors for You | Family Medicine | 670 Illinois Blvd, Hoffman Est, IL 60169-3363 | 2020-09-09 |
| 1245844489 | Jovita Zalwango Nassolo | Family Medicine | 116 1/2 N Benton St Apt 2d, Woodstock, IL 60098-3272 | 2020-09-04 |
| 1720699176 | Healing Hands Resource Center Streator | Family Medicine | 2128 S Central Park Ave, Chicago, IL 60623-3113 | 2020-08-10 |
| 1417565755 | Ghr Total Health and Consulting | Family Medicine | 11336 Mckenna Dr, Frankfort, IL 60423-8096 | 2020-07-22 |
| 1285251892 | Soe Lwin Oo | Family Medicine | 1625 E 75th St # 1, Chicago, IL 60649-3603 | 2020-06-30 |
| Find all providers with the same taxonomy | ||||
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| 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.