Individual
MICHAEL MARCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
9951 ROCK CUT XING, LOVES PARK, IL 61111-1999
(815) 639-8500
(815) 639-8501
Mailing address
9951 ROCK CUT XING, LOVES PARK, IL 61111-1999
(815) 639-8500
(815) 639-8501
Taxonomy
Speciality
Code
Description
License number
State
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
036066998
IL
207Q00000X
Family Medicine Physician
Primary
036066998
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
36066998
—
IL
Enumeration date
07/03/2006
Last updated
08/18/2014
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