Individual
DR. MARVIN J. DERRICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
611 W PARK ST, URBANA, IL 61801-2529
(217) 904-7000
(217) 904-7748
Mailing address
611 W PARK ST, URBANA, IL 61801-2529
Taxonomy
Speciality
Code
Description
License number
State
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
036123699
IL
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
G47855
CA
Other
Enumeration date
09/25/2006
Last updated
10/06/2021
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