Plunkett, Mark D

Plunkett, Mark D is an individual health care provider with primary practice located at 420 Ne Glen Oak Ave Ste 301 Suite 301, Peoria IL 61603-3169. He recently has only one registered license in Allopathic & Osteopathic Physicians / Thoracic Surgery (Cardiothoracic Vascular Surgery), which is considered as his primary health care specialty. Plunkett, Mark D can be contacted via phone (309) 655-3453.

Contact Information

Primary practice address
420 Ne Glen Oak Ave Ste 301 Suite 301 Peoria IL 61603-3169
Phone: (309) 655-3453
Fax: (309) 624-3852
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Thoracic Surgery (Cardiothoracic Vascular Surgery) 208G00000X 42233 Kentucky
Allopathic & Osteopathic Physicians / Thoracic Surgery (Cardiothoracic Vascular Surgery) 208G00000X 86428 Georgia
Allopathic & Osteopathic Physicians / Thoracic Surgery (Cardiothoracic Vascular Surgery) 208G00000X 036-093440 Illinois

Profile Details

NPI number 1518991074
LBN Legal business name Plunkett, Mark D
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 10th, 2006
Last updated Jan 6th, 2023 - about last year

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 1518991074 NPPES
California MEDICAID 00G809460
California MEDICAID 7100053080

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