Favila, Marlito P.
Favila, Marlito P. is an individual health care provider with primary practice located at 1437 E College Ave , Normal IL 61761-2085. He recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as his primary health care specialty. Favila, Marlito P. can be contacted via phone (309) 454-4411.Contact Information
Primary practice address
1437 E College Ave
Normal IL 61761-2085
Phone: (309) 454-4411
Fax: (309) 454-6951
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | Illinois |
Profile Details
| NPI number | 1114945912 |
|---|---|
| LBN Legal business name | Favila, Marlito P. |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 18th, 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1114945912 | NPPES |
| Other | 5715395 | BLUE CROSS BLUE SHIELD |
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