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NPI Code Detail

MEDICARE: MICHELLE M BURK DO

MEDICARE: MICHELLE M BURK DO
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
1207P00000XEmergency Medicine Physician036-107561IL
2207RG0300XGeriatric Medicine (Internal Medicine) Physician036107561IL
3207R00000XInternal Medicine Physician036-107561IL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1093817355
Entity Type Code : Individual
Provider Name (Legal Business Name) : MICHELLE M BURK DO
Provider Business Mailing Address
First Line : 4315 MEMORIAL DR
Second Line :
City : BELLEVILLE
State : IL
Zip : 62226-5342
Country : US
Telephone Number : 618-257-6220
Fax Number :
Provider Business Practice Location Address
First Line : 4315 MEMORIAL DR
Second Line :
City : BELLEVILLE
State : IL
Zip : 62226-5342
Country : US
Telephone Number : 618-257-6220
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/05/2006
Last Update Date : 06/12/2025

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