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Individual

MARK STEPHEN HALL

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
808 RICKERT DR STE 103, NAPERVILLE, IL 60540-0908
(331) 551-5854
(630) 348-3098
Mailing address
1860 PAYSPHERE CIR, CHICAGO, IL 60674-0018
(630) 469-9200

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
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