Individual
DR. MARK D PLUNKETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
420 NE GLEN OAK AVE STE 301, SUITE 301, PEORIA, IL 61603-3169
(309) 655-3453
(309) 624-3852
Mailing address
420 NE GLEN OAK AVE STE 301, SUITE 301, PEORIA, IL 61603-3169
(309) 655-3453
(309) 624-3852
Taxonomy
Speciality
Code
Description
License number
State
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
036-093440
IL
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
42233
KY
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
86428
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G809460
—
CA
05
—
7100053080
—
KY
Enumeration date
07/10/2006
Last updated
01/06/2023
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