Individual
MARK KENNETH MAGNUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
1455 E GOLF RD STE 110, DES PLAINES, IL 60016-1253
(847) 390-7666
(847) 390-9345
Mailing address
PO BOX 4340, DES PLAINES, IL 60016-0014
(847) 390-7666
(847) 390-9345
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
1138
WI
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
016005815
IL
213ES0103X
Foot & Ankle Surgery Podiatrist
1138
WI
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/29/2016
Last updated
04/29/2019
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