Individual
DR. JAN MICHAEL DULALAS RACOMA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1000 HEALTH CENTER DR, MATTOON, IL 61938-4644
(217) 258-4325
Mailing address
PO BOX 2147, FORT MYERS, FL 33902-2147
(239) 628-3192
(407) 647-5431
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
036156826
IL
207R00000X
Internal Medicine Physician
Primary
125.072201
IL
208M00000X
Hospitalist Physician
036156826
IL
208M00000X
Hospitalist Physician
ME175050
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
121456500
—
FL
Enumeration date
06/21/2018
Last updated
02/09/2026
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