Flack, John Mark
Flack, John Mark is an individual health care provider with primary practice located at 751 N Rutledge St Suite 1100, Springfield IL 62702-4968. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Hypertension Specialist. Allopathic & Osteopathic Physicians / Hypertension Specialist is his primary health care specialty. Flack, John Mark can be contacted via phone (217) 545-8000.Contact Information
Primary practice address
751 N Rutledge St Suite 1100
Springfield IL 62702-4968
Phone: (217) 545-8000
Fax: (217) 545-4735
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | 036-138254 | Illinois |
| Allopathic & Osteopathic Physicians / Hypertension Specialist | 207RH0005X | 036-138254 | Illinois |
Profile Details
| NPI number | 1164450987 |
|---|---|
| LBN Legal business name | Flack, John Mark |
| Credentials | MD, MPH |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 29th, 2006 |
| Last updated | Oct 21st, 2020 - 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1164450987 | NPPES |
| Illinois | MEDICAID | 036138254 |
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