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Individual
DR. MARCUS S DERANIAN
Active
Individual
DR. MARCUS S DERANIAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
036069820
IL
152WC0802X
Corneal and Contact Management Optometrist
036069820
IL
207W00000X
Ophthalmology Physician
Primary
036-069820
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036069820
—
IL
01
—
180033361
RAILROAD MEDICARE
IL
01
—
374073
HEALTHLINK
IL
01
—
49175
PERSONAL CARE
IL
Enumeration date
04/25/2006
Last updated
11/20/2009
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