Dolz, Mark Stephan

Dolz, Mark Stephan is an individual health care provider with primary practice located at 1600 W Walnut Passavant Area Hospital - Laboratory, Jacksonville IL 62650. He recently has only one registered license in Allopathic & Osteopathic Physicians / Anatomic Pathology & Clinical Pathology, which is considered as his primary health care specialty. Dolz, Mark Stephan can be contacted via phone (217) 245-9541.

Contact Information

Primary practice address
1600 W Walnut Passavant Area Hospital - Laboratory Jacksonville IL 62650
Phone: (217) 245-9541
Fax: (217) 479-5648
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Anatomic Pathology & Clinical Pathology 207ZP0102X Illinois

Profile Details

NPI number 1104833631
LBN Legal business name Dolz, Mark Stephan
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 1st, 2006
Last updated Jul 8th, 2007 - about 17 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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Identifiers

StateTypeNumberIssuer
All States NPI 1104833631 NPPES
Illinois MEDICAID 0360944131

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