Individual
MARIO J MARCINCZYK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1 MEMORIAL DR, ALTON, IL 62002-6722
(618) 463-7311
Mailing address
PO BOX 1125, MARYLAND HEIGHTS, MO 63043-0125
(888) 731-1036
(423) 892-5838
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
036.095452
IL
207L00000X
Anesthesiology Physician
2005024595
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036095452
—
IL
01
—
203133
BCBS
MO
05
—
207562307
—
MO
01
—
P00316808
RR MEDICARE
—
Enumeration date
05/26/2006
Last updated
10/09/2023
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