Individual
MARK STEPHEN HALL
Active
Individual
MARK STEPHEN HALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
036105135
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036105135 1
—
IL
01
—
0451530938
BLUE SHIELD
IL
01
—
363596417001
TRICARE
IL
01
—
930128279
RAILROAD MEDICARE
IL
Enumeration date
04/19/2007
Last updated
01/20/2022
Update your record
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