Derrick, Marvin J.

Derrick, Marvin J. is an individual health care provider with primary practice located at 611 W Park St , Urbana IL 61801-2529. He recently has only one registered license in Allopathic & Osteopathic Physicians / Thoracic Surgery (Cardiothoracic Vascular Surgery), which is considered as his primary health care specialty. Derrick, Marvin J. can be contacted via phone (217) 904-7000.

Contact Information

Primary practice address
611 W Park St Urbana IL 61801-2529
Phone: (217) 904-7000
Fax: (217) 904-7748
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Thoracic Surgery (Cardiothoracic Vascular Surgery) 208G00000X G47855 California
Allopathic & Osteopathic Physicians / Thoracic Surgery (Cardiothoracic Vascular Surgery) 208G00000X 036123699 Illinois

Profile Details

NPI number 1497855886
LBN Legal business name Derrick, Marvin J.
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 25th, 2006
Last updated Oct 6th, 2021 - about 4 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.

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