Individual
MARK LOUIS WESTPHAL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
665 E LAKE RD, CARBONDALE, IL 62901-5347
(618) 549-0841
(618) 529-2442
Mailing address
PO BOX 399, CARBONDALE, IL 62903-0399
(618) 549-0841
(618) 529-2442
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
036055065
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0003900142
BLUE CROSS BL SH OF IL
IL
01
—
027382
HEALTH ALLIANCE
IL
01
—
1073255002
CIGNA
IL
01
—
110858
HEALTHLINK
IL
Enumeration date
12/04/2006
Last updated
02/05/2024
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