Individual
MR. JOHN D MARSHALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
8600 N STATE ROUTE 91, SUITE 250, PEORIA, IL 61615-9541
(309) 692-5393
(309) 692-2583
Mailing address
8600 N STATE ROUTE 91, SUITE 250, PEORIA, IL 61615-9541
(309) 692-5393
(309) 692-2583
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
036090099
IL
207LP2900X
Pain Medicine (Anesthesiology) Physician
036090099
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036090099
—
IL
Enumeration date
10/21/2005
Last updated
03/07/2019
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