National Provider Identifier Database

LYLE PAHNKE, MD – NPI #1770538225
Vascular Surgery

A surgeon with expertise in the management of surgical disorders of the blood vessels, excluding the intracranial vessels or the heart.


Contact Information

LYLE PAHNKE, MD
302 BROADWAY ST
MOUNT VERNON, IL62864
Phone: 618-242-4750
Fax: 618-242-7674
Website:
Specialty Taxonomy Code
* Vascular Surgery 2086S0129X
Family Medicine 207Q00000X
Surgery 208600000X

* Indicates primary specialty

NPI Profile & details for LYLE PAHNKE

NPI Number 1770538225
Credentials MD
Entity Individual
Enumeration date 05/23/2006
Last updated 04/15/2022 - About 4 years ago
Sole proprietor1 No
Identifiers
  • IL License #: 036089773
  • IL Medicaid: 036089773
  • IL Other: 207988 GROUP
  • IL Other: CG2264 RR GROUP NUMBER
  • IL Other: P00169541 RR MEDICARE NUMBER
Hospital affiliation n/a

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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