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Individual

MR. JOHN M PARGULSKI

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.O.

Contact information

Practice address
619 E MASON ST STE 4P57, SPRINGFIELD, IL 62701-1034
(217) 788-0706
(217) 525-2535
Mailing address
619 E MASON ST STE 4P57, SPRINGFIELD, IL 62701-1034
(217) 788-0706
(217) 525-2535

Taxonomy

Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
03035
IA
207RC0000X
Cardiovascular Disease Physician
Primary
036.145032
IL
207RC0000X
Cardiovascular Disease Physician
3035
IA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000014459
GROUP MISSOURI MEDICARE
MO
05
0140798
IA
01
060040783
RAILROAD MEDICARE
IA
05
1629051958
IA
01
CD4547
RR GROUP NUMBER
IA
Enumeration date
11/21/2005
Last updated
07/12/2022
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