| Doctor Name: | MARK FERRELL |
| NPI Number: | 1972931921 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | RT(R) |
| License Number: | RHF00097620 |
| Business Practice Address: | 702 Spruce St Pana, IL - 625571869 |
| Business Phone Number: | 2178253677 |
| Business Fax Number: | |
| Mailing Address: | 702 Spruce St, PANA |
| State: | IL |
| Postal Code: | 625571869 |
| Phone Number: | 2178253677 |
| Fax Number: | |
| NPI Enumeration Date: | 10/29/2013 |
| NPI Last Update Date: | 10/29/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 2471C1106X |
| License Number: | RHF00097620 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | CA |
| Taxonomy Type: | Technologists, Technicians & Other Technical Service Providers |
| Taxonomy Classification: | Radiologic Technologist |
| Taxonomy Specialization: | Cardiac-Interventional Technology |
| Taxonomy Definition: | |