Individual
DR. MARK M MONDUL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
2401 KANEVILLE RD, SUITE 6, GENEVA, IL 60134-2579
(630) 232-1013
(630) 232-1014
Mailing address
PO BOX 762, GENEVA, IL 60134-0762
(630) 232-1013
(630) 232-1014
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
16003529
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
60001518
BCBS
IL
01
—
L016614
CHAMPUS
—
Enumeration date
09/13/2006
Last updated
11/01/2007
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