Kristofer J. Mitchell
Surgeon Trauma Surgeon Surgical Critical Care
800 N 1st St
Springfield
, Illinois 62702-3719
Kristofer J. Mitchell
Surgeon Trauma Surgeon Surgical Critical Care
800 N 1st St
Springfield
, Illinois 62702-3719
(217) 528-7541
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About
Features
Specialties
- Surgeon
- Surgical Critical Care
- Trauma Surgeon
Languages spoken
- English
Location
First Address
- Kristofer J. Mitchell
- 1025 S 6th St
- Springfield, IL
- Zip : 62703-2403
- Phone : (217) 528-7541
Second Address
- Kristofer J. Mitchell
- 800 N 1st St
- Springfield, IL
- Zip : 62702-3719
- Phone : (217) 528-7541
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 208200000X | Surgeon | 036120394 | IL |
| Y | 208600000X | Surgeon | 036120394 | IL |
| N | 2086S0102X | Surgical Critical Care | 036120394 | IL |
| N | 2086S0127X | Trauma Surgeon | 036120394 | IL |
National Provider Identifier
| NPI | 1205040664 |
|---|---|
| Provider Name | Kristofer J. Mitchell |
| First Address | Springfield, IL 62703-2403 |
| Second Address | Springfield, IL 62702-3719 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 09/05/2007 |
| Last Update Date | 31/01/2022 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 036120394 | (05) | IL |
| R01662 | MEDICARE PTAN (01) | IL |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.