Individual
DR. MARK A PASSERMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
101 S PRAIRIE AVE, DWIGHT, IL 60420
(815) 584-3291
(815) 584-3475
Mailing address
725 SCHOOL ST STE A, MORRIS, IL 60450-1207
(815) 941-9124
(815) 941-4363
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
036-116449
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036116449-1
—
IL
Enumeration date
08/17/2006
Last updated
06/14/2021
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