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Idol Ray Mitchell, DPM
Podiatrist in Macomb, Illinois
NPI 1508850694

Idol Ray Mitchell is a Podiatrist based in Macomb, IL. Idol Ray Mitchell practices in Macomb, IL and has the professional credentials of DPM. The NPI Number for Idol Ray Mitchell is 1508850694 and holds a License No. 016-004683 (Illinois).

The current practice location address for Idol Ray Mitchell is 437 East Grant Street, Macomb, IL and can be reached out via phone at 309-837-3964 and via fax at 309-837-3966.

Location: 437 East Grant Street, Macomb, IL, 61455-3352
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1508850694
Provider Name
Idol Ray Mitchell
Credential
DPM
Provider Entity Type
Individual
Gender
Male
Address
437 East Grant Street, Macomb, IL, 61455-3352
Phone Number
309-837-3964
Fax Number
309-837-3966
Provider Enumeration Date
09/06/2005
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
4452210001 01 DMERC
480034728 01 RAILROAD MEDICARE PROV #
016004683 05 IL
214428 01 IL MEDICARE ID
institution
Provider Business Practice Location Address Details
Address
437 East Grant Street
City
Macomb
State
Illinois
Zip
61455-3352
Phone Number
309-837-3964
Fax Number
309-837-3966
person
Provider Business Mailing Address Details
Address
437 East Grant Street
City
Macomb
State
Illinois
Zip
61455-3352
Phone Number
309-837-3964
Fax Number
309-837-3966
person
Provider's Taxonomy Details 1
Type
Podiatric Medicine & Surgery Service Providers
Classification
Podiatrist
Speciality
-
Taxonomy
213E00000X
License No.
016-004683 (Illinois)
Definition
A podiatrist is a person qualified by a Doctor of Podiatric Medicine (D.P.M.) degree, licensed by the state, and practicing within the scope of that license. Podiatrists diagnose and treat foot diseases and deformities. They perform medical, surgical and other operative procedures, prescribe corrective devices and prescribe and administer drugs and physical therapy.
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