Individual
MARK AMDUR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
6201 ROOSEVELT RD, BERWYN, IL 60402-1108
(708) 386-0845
Mailing address
4250 N MARINE DR, SUITE 236, CHICAGO, IL 60613-1744
(773) 404-0160
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
036044305
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036044305
—
IL
Enumeration date
06/27/2006
Last updated
12/23/2019
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