Provider Demographics
NPI:1841494606
Name:ANTHONY F MOLINARI MD LLC
Entity type:Organization
Organization Name:ANTHONY F MOLINARI MD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:F
Authorized Official - Last Name:MOLINARI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:815-544-1007
Mailing Address - Street 1:303 ANDREWS DR
Mailing Address - Street 2:
Mailing Address - City:BELVIDERE
Mailing Address - State:IL
Mailing Address - Zip Code:61008-3918
Mailing Address - Country:US
Mailing Address - Phone:815-544-1007
Mailing Address - Fax:815-547-6109
Practice Address - Street 1:303 ANDREWS DR
Practice Address - Street 2:
Practice Address - City:BELVIDERE
Practice Address - State:IL
Practice Address - Zip Code:61008-3918
Practice Address - Country:US
Practice Address - Phone:815-544-1007
Practice Address - Fax:815-547-6109
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-13
Last Update Date:2012-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
209534Medicare ID - Type Unspecified