Nelson, Mark
Nelson, Mark is an individual health care provider with primary practice located at 150 E Willow Ave Ste 300 , Wheaton IL 60187-5529. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Nelson, Mark can be contacted via phone (630) 510-6900.Contact Information
Primary practice address
150 E Willow Ave Ste 300
Wheaton IL 60187-5529
Phone: (630) 510-6900
Fax: (630) 871-6706
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 036072356 | Illinois |
Profile Details
| NPI number | 1942277942 |
|---|---|
| LBN Legal business name | Nelson, Mark |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Mar 8th, 2006 |
| Last updated | Feb 24th, 2021 - about 3 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 | 1942277942 | NPPES |
| Illinois | MEDICAID | 036072356 |
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