Individual provider · NPI-1
Mark Ferrell, RT(R)
Radiologic Technologist, Cardiac-Interventional Technology · Pana, IL
NPI number1972931921
StatusActive
Last updated in NPPESOct 29, 2013
Details
- NPI
- 1972931921
- Entity type
- Individual (NPI-1)
- Name
- Mark Ferrell
- Credential
- RT(R)
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Oct 29, 2013
- Last updated
- Oct 29, 2013
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 2471C1106X | Radiologic Technologist, Cardiac-Interventional Technology | 500501702 | IL | Yes |
| 2471C1106X | Radiologic Technologist, Cardiac-Interventional Technology | RHF00097620 | CA | |
| 2471C1106X | Radiologic Technologist, Cardiac-Interventional Technology | 00-6456 | SC |
Practice location
702 Spruce StPana, IL 62557-1869
Phone 217-825-3677
Mailing address
702 Spruce StPana, IL 62557-1869
Phone 217-825-3677
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