Individual
JOHN D. MELLINGER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
747 N RUTLEDGE ST, 5TH FLOOR, SPRINGFIELD, IL 62702-6700
(217) 545-5878
(217) 545-0040
Mailing address
PO BOX 19638, SPRINGFIELD, IL 62794-9638
(217) 545-5878
(217) 545-0040
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
036-124378
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000962552A
—
GA
05
—
036124378
—
IL
05
—
G51984
—
SC
Enumeration date
08/30/2006
Last updated
11/04/2020
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