Individual
TODD C ZISHOLTZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
200 HEALTH CARE DR, GREENVILLE, IL 62246-1154
(618) 664-1230
Mailing address
1040 SIERRA DR, SUITE 400, GREENWOOD, IN 46143-7240
(317) 865-8988
(317) 859-8590
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
036130871
IL
207P00000X
Emergency Medicine Physician
EMTL-2021-026
GU
207P00000X
Emergency Medicine Physician
Primary
M-2285
GU
207Q00000X
Family Medicine Physician
036130871
IL
207Q00000X
Family Medicine Physician
M-2285
GU
207Q00000X
Family Medicine Physician
ME94395
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036130871
—
IL
01
—
IL5686073
MEDICARE PTAN
IL
Enumeration date
07/05/2006
Last updated
03/07/2023
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