Individual
DR. JOHN S MARSHALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1001 MAIN STREET, 3RD FLOOR, PEORIA, IL 61606-2037
(309) 495-0200
Mailing address
1001 MAIN STREET, 3RD FLOOR, PEORIA, IL 61606-2037
(309) 495-0200
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
036070170
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036070170-1
—
IL
01
—
7215166
BCBS
IL
Enumeration date
07/03/2006
Last updated
11/13/2012
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