Individual
MARK E UNZICKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
611 W. PARK ST., ANESTHESIOLOGY, URBANA, IL 61801
(217) 383-3141
(217) 383-3265
Mailing address
611 W. PARK ST., BWPC, URBANA, IL 61801-2500
(217) 383-6792
(217) 383-4752
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
209000436
IL
367500000X
Certified Registered Nurse Anesthetist
28119666A
IN
Other
Enumeration date
12/27/2006
Last updated
06/13/2016
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