Individual
MARK EMENECKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
116 W BUCHANAN AVE, CHARLESTON, IL 61920-2522
(217) 345-7700
(217) 345-7200
Mailing address
1005 HEALTH CENTER DR STE 201, MATTOON, IL 61938-4693
(217) 238-6055
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
036-104851
IL
Other
Enumeration date
08/21/2006
Last updated
04/15/2021
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