MEDICARE: JOSEPH FLINT MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208000000X	Pediatrics Physician	036-112406	IL

General Provider Information

NPI Number	:	1013064195
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOSEPH FLINT MD

Provider Business Mailing Address
First Line	:	101 E 5TH ST
Second Line	:
City	:	DELAVAN
State	:	IL
Zip	:	61734-9619
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	101 E 5TH ST
Second Line	:
City	:	DELAVAN
State	:	IL
Zip	:	61734-9619
Country	:	US
Telephone Number	:	309-696-2216
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/04/2007
Last Update Date	:	05/18/2012

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