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Individual

DR. MILDRED S. NELSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
912 N HENRIETTA ST, EFFINGHAM, IL 62401-1788
(217) 342-3337
(217) 347-3328
Mailing address
PO BOX 784, EFFINGHAM, IL 62401-0784
(217) 342-3337
(217) 347-3328

Taxonomy

Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
036-078190
IL
207V00000X
Obstetrics & Gynecology Physician
DR.0052105
CO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
036078190 1
IL
01
160015626
RAILROAD MEDICARE
01
279500
MEDICARE GROUP
Enumeration date
08/03/2006
Last updated
07/19/2023
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