Cormier, Mark Edward
Cormier, Mark Edward is an individual health care provider with primary practice located at 351 Executive Pkwy , Rockford IL 61107-5339. He recently has only one registered license in Allopathic & Osteopathic Physicians / Urology, which is considered as his primary health care specialty. Cormier, Mark Edward can be contacted via phone (815) 398-4057.Contact Information
Primary practice address
351 Executive Pkwy
Rockford IL 61107-5339
Phone: (815) 398-4057
Fax: (815) 398-0220
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Urology | 208800000X | 036080935 | Illinois |
Profile Details
| NPI number | 1922078401 |
|---|---|
| LBN Legal business name | Cormier, Mark Edward |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jan 25th, 2006 |
| Last updated | Nov 19th, 2009 - about 15 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1922078401 | NPPES |
| Illinois | MEDICAID | 036080935 |
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