Douglas, Margie

Douglas, Margie is an individual health care provider with primary practice located at 619 E Mason St Suite 4P57, Springfield IL 62701-1034. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Adult Health, which is considered as her primary health care specialty. Douglas, Margie can be contacted via phone (217) 788-0706.

Contact Information

Primary practice address
619 E Mason St Suite 4P57 Springfield IL 62701-1034
Phone: (217) 788-0706
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Adult Health 363LA2200X 209008390 Illinois

Profile Details

NPI number 1154623585
LBN Legal business name Douglas, Margie
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 17th, 2010
Last updated Mar 12th, 2013 - about 13 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 1154623585 NPPES
Illinois Other P00907053 RR MEDICARE

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