Deyoung, Mark B
Deyoung, Mark B is an individual health care provider with primary practice located at 1024 N Magnolia St , Elmwood IL 61529-9602. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Deyoung, Mark B can be contacted via phone (309) 742-6334.Contact Information
Primary practice address
1024 N Magnolia St
Elmwood IL 61529-9602
Phone: (309) 742-6334
Fax: (309) 647-6880
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 036108454 | Illinois |
Profile Details
| NPI number | 1306845045 |
|---|---|
| LBN Legal business name | Deyoung, Mark B |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 15th, 2005 |
| Last updated | Feb 21st, 2022 - about 2 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 | 1306845045 | NPPES |
| Illinois | MEDICAID | 0361084541 |
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