Individual
MICHAEL E MULLIGAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3 JUNCTION DR W, GLEN CARBON, IL 62034-2916
(618) 288-5088
Mailing address
3 JUNCTION DR W, GLEN CARBON, IL 62034-2916
(618) 288-5088
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
036078912
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036078712
—
IL
01
—
080021119
RR MEDICARE
IL
01
—
102922
HEALTHLINK
—
01
—
4322029
UNITED HEALTHCARE
—
01
—
4622029
ADMINISTAR
IL
01
—
6015373
BCBS
IL
01
—
N4862
GROUP HEALTH PLAN
—
Enumeration date
06/24/2005
Last updated
05/18/2011
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