Montefolka, Mark
Montefolka, Mark is an individual health care provider with primary practice located at 1120 E War Memorial Dr , Peoria Heights IL 61616. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Montefolka, Mark can be contacted via phone (309) 685-0100.Contact Information
Primary practice address
1120 E War Memorial Dr
Peoria Heights IL 61616
Phone: (309) 685-0100
Fax: (309) 685-0172
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 036110139 | Illinois |
Profile Details
| NPI number | 1114026754 |
|---|---|
| LBN Legal business name | Montefolka, Mark |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Sep 21st, 2006 |
| Last updated | Jul 9th, 2007 - about 19 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 | 1114026754 | NPPES |
| Illinois | Other | K09678 | PIN |
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