Mark L Day, M.D.
Individual provider Active NPI Internal Medicine Physician · Staunton, IL
NPI 1174679237 · NPPES record last updated Sep 29, 2020
Key facts
- NPI
- 1174679237
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Internal Medicine Physician 207R00000X
- License
- 036.117437 (IL)
- Practice address
- 400 N Caldwell St
Staunton, IL 62088-1173 - Phone
- (618) 635-2200
- Fax
- (618) 635-3400
- NPI assigned
- Jan 25, 2007
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IL
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20070417000325 | IL | Practitioner - Internal Medicine |
1254436439 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036.117437 | IL | MD | Internal Medicine Physician |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emergency Medicine Physician | 207P00000X | 036.117437 | IL | |
| Critical Access Hospital | 282NC0060X | |||
| Internal Medicine Physician | 207R00000X | 036.117437 | IL | Yes |
Addresses
Primary practice location
400 N Caldwell St
Staunton, IL 62088-1173
Mailing address
200 Corporate Blvd
Lafayette, LA 70508-3870
Phone (800) 893-9698
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 036117437 | Other | IL | ILLIONIS MEDICAID |
Other names
- Dr. Mark Lee Day
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All providers in Staunton, IL · Internal Medicine Physician in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 29, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.