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Individual

MARK S PUCZYNSKI

Active
Sole proprietor

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
301 N 8TH ST, SPRINGFIELD, IL 62701-1041
(217) 545-7732
(217) 545-4117
Mailing address
PO BOX 19639, SPRINGFIELD, IL 62794-9639
(217) 545-7578
(217) 545-1884

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
IL

Other

Enumeration date
11/18/2005
Last updated
07/08/2007
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