Doctor Name: | MARC SCHOLES |
NPI Number: | 1518327550 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | NP |
License Number: | 209013957 |
Business Practice Address: | 101 E 9th St Pana, IL - 625571716 |
Business Phone Number: | 2175622544 |
Business Fax Number: | 2175626228 |
Mailing Address: | 101 E 9th St, PANA |
State: | IL |
Postal Code: | 625571716 |
Phone Number: | 2175622544 |
Fax Number: | 2175626228 |
NPI Enumeration Date: | 03/03/2016 |
NPI Last Update Date: | 03/03/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | 209013957 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IL |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |