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Individual

DR. MARK J HSU

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
5405 NORTH KNOXVILLE AVENUE, PEORIA, IL 61614
(309) 691-4410
(309) 589-2830
Mailing address
5405 NORTH KNOXVILLE AVENUE, PEORIA, IL 61614
(309) 691-4410
(309) 589-2830

Taxonomy

Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
036-101389
IL
207RC0000X
Cardiovascular Disease Physician
036101389
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
036-101389
IL
05
036101389
IL
Enumeration date
07/04/2006
Last updated
08/06/2010
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