Individual
MR. MARLON TAN MUNESES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
101 E 9TH ST, PANA, IL 62557-1716
(217) 562-2544
(217) 562-6288
Mailing address
101 E 9TH ST, PANA, IL 62557-1716
(217) 562-2544
(217) 562-6288
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
036096593
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036096593
—
IL
01
—
069003
HEALTH ALLIANE
—
01
—
080173568
RAILROAD MEDICARE
—
01
—
109744
PERSONAL CARE
—
01
—
1832428
UNITED HEALTHCARE
—
01
—
384581
UNITED MEDICAL RESOURCES
—
01
—
5369708
AETNA
—
01
—
5827807
BLUE CROSS BLUE SHIELD
IL
Enumeration date
10/24/2005
Last updated
02/26/2021
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