# MARK L. LUNDINE M.D. P.C.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1316138522
- **Authorized official:** MARK L LUNDINE (PRESIDENT)
- **Authorized official phone:** (815) 226-1800

## Contact information

- **Practice address:** 6979 REDANSA DR, ROCKFORD, IL 61108-1201
- **Practice address phone:** (815) 226-1800
- **Mailing address:** 6979 REDANSA DR, ROCKFORD, IL 61108-1201

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207YS0123X | Facial Plastic Surgery Physician | 336023733 | IL | Yes |

## Other

- **Enumeration date:** 08/05/2007
- **Last updated:** 10/28/2007