Organization
MARK L. LUNDINE M.D. P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARK L LUNDINE (PRESIDENT)
(815) 226-1800
Entity
Organization
Contact information
Practice address
6979 REDANSA DR, ROCKFORD, IL 61108-1201
(815) 226-1800
Mailing address
6979 REDANSA DR, ROCKFORD, IL 61108-1201
Taxonomy
Speciality
Code
Description
License number
State
207YS0123X
Facial Plastic Surgery Physician
Primary
336023733
IL
Other
Enumeration date
08/05/2007
Last updated
10/28/2007
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