MEDICARE: MARIO E COTE M.D.

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	207R00000X	Internal Medicine Physician	036079954	IL

General Provider Information

NPI Number	:	1376514273
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARIO E COTE M.D.

Provider Business Mailing Address
First Line	:	1302 N GREENWOOD ST
Second Line	:
City	:	SPRING VALLEY
State	:	IL
Zip	:	61362-1576
Country	:	US
Telephone Number	:	309-246-2676
Fax Number	:

Provider Business Practice Location Address
First Line	:	1302 N GREENWOOD ST
Second Line	:
City	:	SPRING VALLEY
State	:	IL
Zip	:	61362-1576
Country	:	US
Telephone Number	:	309-246-2676
Fax Number	:

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

Provider Enumeration Date	:	01/30/2006
Last Update Date	:	10/01/2024

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