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General NPI Number Information
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NPI Number | 1386675809
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Entity Type | Individual
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Provider Name | TODD C ZISHOLTZ MD
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Gender | Male
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Dates
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Enumeration Date | 07/05/2006
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Last Update Date | 03/07/2023
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Provider Practice Location Address
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Address Line | 200 HEALTH CARE DR
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City | GREENVILLE
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State | IL
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Zip | 62246-1154
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Country | US
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Telephone | 618-664-1230
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Fax |
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Provider Business Mailing Address
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Address Line | 1040 SIERRA DR SUITE 400
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City | GREENWOOD
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State | IN
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Zip | 46143-7240
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Country | US
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Telephone | 317-865-8988
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Fax | 317-859-8590
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 036130871
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | EMTL-2021-026
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License Number State | GU
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Taxonomy #3
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | M-2285
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License Number State | GU
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Taxonomy #4
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 036130871
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License Number State | IL
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Taxonomy #5
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | ME94395
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License Number State | FL
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Taxonomy #6
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | M-2285
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License Number State | GU
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