Provider Demographics
NPI:1407816044
Name:FLYNN, SEAN F (MD)
Entity Type:Individual
Prefix:DR
First Name:SEAN
Middle Name:F
Last Name:FLYNN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1005 HEALTH CENTER DR STE 201
Mailing Address - Street 2:
Mailing Address - City:MATTOON
Mailing Address - State:IL
Mailing Address - Zip Code:61938-4653
Mailing Address - Country:US
Mailing Address - Phone:217-868-2812
Mailing Address - Fax:
Practice Address - Street 1:905 N MAPLE ST STE E
Practice Address - Street 2:
Practice Address - City:EFFINGHAM
Practice Address - State:IL
Practice Address - Zip Code:62401-6401
Practice Address - Country:US
Practice Address - Phone:217-347-7030
Practice Address - Fax:217-347-7197
Is Sole Proprietor?:No
Enumeration Date:2006-03-27
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036104430207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL371391171003Medicaid
IL461699OtherHEALTHLINK
IL0032540072OtherBLUE CROSS BLUE SHIELD IL
170989OtherPERSONAL CARE
IL076638OtherHEALTH ALLIANCE
IL080193907OtherRAILROAD MEDICARE
IL036104430OtherILLINOIS LICENSE
IL336065138OtherILLINOIS CONTROLLED SUBSTANCE LICENSE
1351483OtherFIRST HEALTH/ COVENTRY
1351483OtherFIRST HEALTH/ COVENTRY
IL148960Medicare Oscar/Certification
1351483OtherFIRST HEALTH/ COVENTRY
BF7334737OtherDEA #
561920Medicare ID - Type UnspecifiedGROUP MEDICARE