Organization
DENNIS P MLOT MD LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LINDA D MLOT (MANAGER)
(618) 244-6559
Entity
Organization
Contact information
Practice address
2413 BROADWAY ST, MOUNT VERNON, IL 62864-2917
(618) 244-6559
(618) 244-6735
Mailing address
2413 BROADWAY ST, MOUNT VERNON, IL 62864-2917
(618) 244-6559
(618) 244-6735
Taxonomy
Speciality
Code
Description
License number
State
207YX0602X
Otolaryngic Allergy Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
04132003
BCBS ILLINOIS
IL
Enumeration date
10/23/2007
Last updated
08/04/2008
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