Individual
DR. MARK B DEYOUNG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1024 N MAGNOLIA ST, ELMWOOD, IL 61529-9602
(309) 742-6334
(309) 647-6880
Mailing address
180 S MAIN ST, CANTON, IL 61520-2608
(309) 647-0201
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
036108454
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0361084541
—
IL
Enumeration date
07/15/2005
Last updated
02/21/2022
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