Provider Demographics
NPI:1881663250
Name:STRICKLIN, DAVID J (MD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:J
Last Name:STRICKLIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1201 PINE ST
Mailing Address - Street 2:
Mailing Address - City:ELDORADO
Mailing Address - State:IL
Mailing Address - Zip Code:62930-1634
Mailing Address - Country:US
Mailing Address - Phone:618-273-3361
Mailing Address - Fax:618-273-2504
Practice Address - Street 1:1340 IL HIGHWAY 1 STE E
Practice Address - Street 2:
Practice Address - City:CARMI
Practice Address - State:IL
Practice Address - Zip Code:62821
Practice Address - Country:US
Practice Address - Phone:618-380-9321
Practice Address - Fax:618-380-9322
Is Sole Proprietor?:No
Enumeration Date:2006-03-16
Last Update Date:2018-08-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IL036.062936207R00000X
IL036062936207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL370914806002Medicaid
IL036062936Medicaid
IL589280Medicare PIN
ILC74170Medicare UPIN
IL148939Medicare Oscar/Certification