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Contact Information

MITCHELL SUSSMAN, MD
611 W. PARK ST.
RADIOLOGY
URBANA, IL61801
 Phone: 217-383-3270
 Fax: 217-383-4116
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Diagnostic Radiology

2085R0202X 30 Physician/Diagnostic Radiology
Indicates primary specialty

NPI Profile & details for MITCHELL SUSSMAN · (Male)

NPI # 1427097104
Status Active
Credentials MD
Entity Individual
Enumeration date 06/06/2006
Last updated 05/14/2014 - About 12 years ago
Sole proprietor 1 No
Identifiers
  • IL License # 036088537
  • IL License # 36088537
  • IL Medicaid 036088537*3
  • IL Other 0533210001 DMERC
Hospital affiliation(s)
  • CARLE FOUNDATION HOSPITAL - (Acute Care)
    611 WEST PARK STREET
    URBANA, IL 61801
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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