Michael Marck, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

036066998 Issued in IL

Practice address

9951 Rock Cut Xing
Loves Park, IL 61111-1999

Phone

(815) 639-8500

Fax

(815) 639-8501

NPI assigned

Jul 3, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1151884800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1408320000000",
    "number": "1720018161",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9951 ROCK CUT XING",
            "city": "LOVES PARK",
            "state": "IL",
            "postal_code": "611111999",
            "telephone_number": "815-639-8500",
            "fax_number": "815-639-8501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9951 ROCK CUT XING",
            "city": "LOVES PARK",
            "state": "IL",
            "postal_code": "611111999",
            "telephone_number": "815-639-8500",
            "fax_number": "815-639-8501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARCK",
        "first_name": "MICHAEL",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-03",
        "last_updated": "2014-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207PE0004X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Emergency Medical Services",
            "state": "IL",
            "license": "036066998",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036066998",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "36066998",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Becky L Madsen, CRNA
• Thomas Magerl, APN
• Michael Bernard Maloney, DO
• Monica Manhas, MD
• Nadhia Marie Manthuruthil
• Eric Marnul
• Monica Ann Martens, M.D.
• Marissa Martin
• Lawrence D. Mason, M.D.
• James M. Mathers, M.D.

• Family Medicine Physician in Loves Park, IL
• Providers in Loves Park, IL by specialty
• Family Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2014; 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.