Westphal, Mark Louis

Westphal, Mark Louis is an sole proprietor health care provider with primary practice located at 665 E Lake Rd , Carbondale IL 62901-5347. He recently has only one registered license in Allopathic & Osteopathic Physicians / Dermatology, which is considered as his primary health care specialty. Westphal, Mark Louis can be contacted via phone (618) 549-0841.

Contact Information

Primary practice address
665 E Lake Rd Carbondale IL 62901-5347
Phone: (618) 549-0841
Fax: (618) 529-2442
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Dermatology 207N00000X 036055065 Illinois

Profile Details

NPI number 1043388242
LBN Legal business name Westphal, Mark Louis
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Dec 4th, 2006
Last updated Feb 5th, 2024 - about 10 months 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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Identifiers

StateTypeNumberIssuer
All States NPI 1043388242 NPPES
Illinois Other 0003900142 BLUE CROSS BL SH OF IL
Illinois Other 027382 BLUE CROSS BL SH OF IL
Illinois Other 110858 BLUE CROSS BL SH OF IL
Illinois Other 1073255002 BLUE CROSS BL SH OF IL

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