Terrell, Mark R.
Terrell, Mark R. is an individual health care provider with primary practice located at 417 N Arboretum Cir , Wheaton IL 60189-8703. He recently has only one registered license in Allopathic & Osteopathic Physicians / Anesthesiology, which is considered as his primary health care specialty. Terrell, Mark R. can be contacted via phone (630) 364-6564.Contact Information
Primary practice address
417 N Arboretum Cir
Wheaton IL 60189-8703
Phone: (630) 364-6564
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Anesthesiology | 207L00000X | 036089479 | Illinois |
Profile Details
| NPI number | 1194764621 |
|---|---|
| LBN Legal business name | Terrell, Mark R. |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 6th, 2006 |
| Last updated | Mar 18th, 2015 - about 11 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 | 1194764621 | NPPES |
| Illinois | MEDICAID | 036089479 |
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