Provider Demographics
NPI:1942312913
Name:MICHAEL J. MONFILS, M.D., L.L.C.
Entity Type:Organization
Organization Name:MICHAEL J. MONFILS, M.D., L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:J
Authorized Official - Last Name:MONFILS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:815-562-5549
Mailing Address - Street 1:1181 N 8TH ST
Mailing Address - Street 2:
Mailing Address - City:ROCHELLE
Mailing Address - State:IL
Mailing Address - Zip Code:61068-2416
Mailing Address - Country:US
Mailing Address - Phone:815-562-5540
Mailing Address - Fax:815-562-5231
Practice Address - Street 1:1181 N 8TH ST
Practice Address - Street 2:
Practice Address - City:ROCHELLE
Practice Address - State:IL
Practice Address - Zip Code:61068-2416
Practice Address - Country:US
Practice Address - Phone:815-562-5540
Practice Address - Fax:815-562-5231
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-31
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL209032Medicare ID - Type Unspecified