Michelle M Vandorn
Internist Emergency Physician Geriatric Medicine
4315 Memorial Dr
Belleville
, Illinois 62226-5342
Michelle M Vandorn
Internist Emergency Physician Geriatric Medicine
4315 Memorial Dr
Belleville
, Illinois 62226-5342
(618) 257-6220
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About
Features
Specialties
- Emergency Physician
- Internist
- Geriatric Medicine
Languages spoken
- English
Location
First Address
- Michelle M Vandorn
- 4315 Memorial Dr
- Belleville, IL
- Zip : 62226-5342
- Phone : (618) 257-6220
Second Address
- Michelle M Vandorn
- 4315 Memorial Dr
- Belleville, IL
- Zip : 62226-5342
- Phone : (618) 257-6220
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FAQs
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Where is Michelle M Vandorn ’s practice located?
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Is Michelle M Vandorn a sole practitioner?
Is Michelle M Vandorn accepting new patients?
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| N | 207P00000X | Emergency Physician | 036-107561 | IL |
| Y | 207R00000X | Internist | 036-107561 | IL |
| Y | 111NI0900X | Internist | 036-107561 | IL |
| N | 207RG0300X | Geriatric Medicine | 036107561 | IL |
National Provider Identifier
| NPI | 1093817355 |
|---|---|
| Provider Name | Michelle M Vandorn |
| First Address | Belleville, IL 62226-5342 |
| Second Address | Belleville, IL 62226-5342 |
| Gender | F |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 05/09/2006 |
| Last Update Date | 03/01/2020 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 036107561 | (05) | IL |
| 1093817355 | (05) | MO |
| H69161 | (02) |
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.