Deranian, Marcus S

Deranian, Marcus S is an individual health care provider with primary practice located at 2442 N Route 121 , Decatur IL 62526-9461. He recently has 3 registered licenses in different health care specialties including Eye and Vision Services Providers / Optometrist, Eye and Vision Services Providers / Corneal and Contact Management, Allopathic & Osteopathic Physicians / Ophthalmology. Allopathic & Osteopathic Physicians / Ophthalmology is his primary health care specialty. Deranian, Marcus S can be contacted via phone (217) 233-3101.

Contact Information

Primary practice address
2442 N Route 121 Decatur IL 62526-9461
Phone: (217) 233-3101
Fax: (217) 233-3107
Website:
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Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X 036069820 Illinois
Eye and Vision Services Providers / Corneal and Contact Management 152WC0802X 036069820 Illinois
Allopathic & Osteopathic Physicians / Ophthalmology 207W00000X 036-069820 Illinois

Profile Details

NPI number 1952367351
LBN Legal business name Deranian, Marcus S
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 25th, 2006
Last updated Nov 20th, 2009 - about 17 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1952367351 NPPES
Illinois MEDICAID 036069820
Illinois Other 180033361
Illinois Other 374073
Illinois Other 49175

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