Thomas Mark

NPI 1255577649 - Physician Assistant - 363A00000X

NPI Details
NPI 1255577649
Gender Male
Enumeration Date 01/06/2009
Last Updated 01/06/2009
Entity Type Individual
Active Over 7 years ago
Practice Location
370 SUMMIT ST
ELGIN IL, 60120-3843, US
Phone (847) 608-1344
Fax
Business Location
172 LAKESIDE DR
APT. 1916
ST CHARLES IL, 60174-7940, US
Phone
Fax
Toxanomy
Taxonomy Code 363A00000X
License State Illinois
License Number 085003372
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According to our database, Mr. Thomas Mark NPI is 1255577649, taxonomy code is 363A00000X and license number is 085003372, license state is located at Illinois. Thomas Mark physically located at 370 Summit St, Elgin IL, 60120-3843. NPI Number Thomas Mark has the Individual type.

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1255577649 NPI number is provided on an as is basis without warranty of any kind. 1255577649 is maintained by the National Plan & Provider Enumeration System. The contents of Thomas Mark are for informational purposes only.