Sly, Mark

Sly, Mark is an sole proprietor health care provider with primary practice located at 403 N Veterans Pkwy , Bloomington IL 61704-7718. He recently has only one registered license in Pharmacy Service Providers / Geriatric, which is considered as his primary health care specialty. Sly, Mark can be contacted via phone (309) 663-8852.

Contact Information

Primary practice address
403 N Veterans Pkwy Bloomington IL 61704-7718
Phone: (309) 663-8852
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Pharmacy Service Providers / Geriatric 1835G0303X 051295174 Illinois

Profile Details

NPI number 1679848618
LBN Legal business name Sly, Mark
Credentials PHARMD
Entity Individual
Sole proprietor 1 Yes
Enumeration date Mar 8th, 2012
Last updated Mar 8th, 2012 - about 12 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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