Healthcare Provider Details

I. General information

NPI: 1821613407
Provider Name (Legal Business Name): PATRICK MULLIGAN DO
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/10/2020
Last Update Date: 07/02/2025
Certification Date: 07/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

880 W CENTRAL RD STE 8100
ARLINGTON HEIGHTS IL
60005-2391
US

IV. Provider business mailing address

180 HARVESTER DR STE 110
BURR RIDGE IL
60527-6686
US

V. Phone/Fax

Practice location:
  • Phone: 847-255-5030
  • Fax: 847-255-0156
Mailing address:
  • Phone: 773-702-1150
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number125.076650
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code207RI0200X
TaxonomyInfectious Disease Physician
License Number036-173988
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: