Individual
DR. DENNIS PAUL MLOT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2413 BROADWAY ST, MOUNT VERNON, IL 62864-2917
(618) 244-6559
Mailing address
2413 BROADWAY ST, MOUNT VERNON, IL 62864-2917
(618) 244-6559
Taxonomy
Speciality
Code
Description
License number
State
207YX0602X
Otolaryngic Allergy Physician
Primary
036105686
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036105686
—
IL
01
—
04132003
BCBS
IL
Enumeration date
11/02/2006
Last updated
10/24/2007
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