Individual
DR. MARWAN DIB
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1302 FRANKLIN AVE STE 4500, NORMAL, IL 61761-3593
(309) 556-8300
Mailing address
611 W PARK ST, FAPC, URBANA, IL 61801-2500
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
125055543
IL
207RC0000X
Cardiovascular Disease Physician
036151153
IL
207RI0011X
Interventional Cardiology Physician
036151153
IL
207RI0011X
Interventional Cardiology Physician
Primary
64438
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100045134
—
WI
01
—
64438
WI LICENSE
WI
Enumeration date
09/22/2010
Last updated
02/28/2024
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