Individual
MARY TJARKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
600 JOHN DEERE ROAD, SUITE 200, MOLINE, IL 61265-6897
(309) 779-4230
Mailing address
600 JOHN DEERE ROAD, SUITE 200, MOLINE, IL 61265-6897
(309) 779-4230
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
36102741
IL
207V00000X
Obstetrics & Gynecology Physician
5086
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036102741
—
IL
05
—
2533752
—
IA
05
—
6200972
—
SD
Enumeration date
06/28/2006
Last updated
01/04/2011
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