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NPI Code Detail

MEDICARE: MALLORY EINHORN APRN

MEDICARE: MALLORY EINHORN APRN
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
1363LF0000XFamily Nurse Practitioner209.031937IL

General Provider Information

NPI Number : 1962202440
Entity Type Code : Individual
Provider Name (Legal Business Name) : MALLORY EINHORN APRN
Provider Business Mailing Address
First Line : PO BOX 372
Second Line :
City : MATTOON
State : IL
Zip : 61938-0372
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1000 HEALTH CENTER DR
Second Line :
City : MATTOON
State : IL
Zip : 61938-4644
Country : US
Telephone Number : 217-238-4019
Fax Number : 217-238-4336
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/14/2025
Last Update Date : 05/28/2026

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Directions to “ MALLORY EINHORN APRN” Practice Location

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