Marion Diagnostic Center LLC

Primary specialty

Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X

Legal business name

MARION DIAGNOSTIC CENTER LLC

Practice address

3003 Civic Circle Blvd
Marion, IL 62959-5259

Phone

(618) 993-1400

Fax

(618) 993-1522

NPI assigned

Jul 29, 2022

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Lea Wright

Title

Administrator

Phone

(618) 993-1400

Specialties & licenses 1

Addresses

Tax ID family

Marion Diagnostic Center LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Marion Diagnostic Center LLC

  • Diagnostic Radiology Physician
  • Marion, IL
  • NPI 1275006744
  NPD tax ID

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1659052800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1662595200000",
    "number": "1235865452",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3003 CIVIC CIRCLE BLVD",
            "city": "MARION",
            "state": "IL",
            "postal_code": "629595259",
            "telephone_number": "618-993-1400",
            "fax_number": "618-993-1522"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3003 CIVIC CIRCLE BLVD",
            "city": "MARION",
            "state": "IL",
            "postal_code": "629595259",
            "telephone_number": "618-993-1400",
            "fax_number": "618-993-1522"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARION DIAGNOSTIC CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-07-29",
        "last_updated": "2022-09-08",
        "certification_date": "2022-09-08",
        "status": "A",
        "authorized_official_last_name": "WRIGHT",
        "authorized_official_first_name": "LEA",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "618-993-1400"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kevin Marciniak
• David William Marcum, PHARM.D.
• Marion Anesthesia Company LLC
• Marion Chronic Care LTD
• Marion Community Unit Dist 2
• Marion Diagnostic Center LLC
• Marion Diagnostic Center, LLC
• Marion Emergency Physicians, LLC
• Marion Eye Anesthesia Group LLC
• Marion Eye Center Anesthesia Group Inc

• Anatomic Pathology & Clinical Pathology Physician in Marion, IL
• Providers in Marion, IL by specialty
• Anatomic Pathology & Clinical Pathology Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.