Depaz, Mary Anne
Depaz, Mary Anne is an individual health care provider with primary practice located at 210 W. Mckinley Ave Ste 2, Decatur IL 62526. She recently has only one registered license in Allopathic & Osteopathic Physicians / Radiation Oncology, which is considered as her primary health care specialty. Depaz, Mary Anne can be contacted via phone (217) 876-6600.Contact Information
Primary practice address
210 W. Mckinley Ave Ste 2
Decatur IL 62526
Phone: (217) 876-6600
Fax: (217) 876-6606
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Radiation Oncology | 2085R0001X | 036-101577 | Illinois |
Profile Details
| NPI number | 1700846664 |
|---|---|
| LBN Legal business name | Depaz, Mary Anne |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Mar 24th, 2006 |
| Last updated | Feb 26th, 2019 - about 7 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1700846664 | NPPES |
| Illinois | MEDICAID | 036-101577 | |
| Illinois | MEDICAID | 036101577 |
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