NPIMap

Individual provider Active NPI

Mark Mench, M.D.

  • Emergency Medicine Physician
  • Sterling, IL
National Provider Identifier
1750333589
Registry record updated Apr 20, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
036061486 Issued in IL
Practice address
100 E Le Fevre Rd
Sterling, IL 61081-1278
Phone
(815) 625-0400
Fax
(815) 625-2747
NPI assigned
May 17, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 036061486 IL Primary

Addresses

Primary practice location

100 E Le Fevre Rd
Sterling, IL 61081-1278

Mailing address

100 E Le Fevre Rd
Sterling, IL 61081-1278
Phone (815) 625-0400

Other identifiers 1

IdentifierTypeStateIssuer
010033947OtherILRAILROAD MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

NPI Registry JSON

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

{
    "created_epoch": "1147824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1334880000000",
    "number": "1750333589",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 E LE FEVRE RD",
            "city": "STERLING",
            "state": "IL",
            "postal_code": "610811278",
            "telephone_number": "815-625-0400",
            "fax_number": "815-625-2747"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 E LE FEVRE RD",
            "city": "STERLING",
            "state": "IL",
            "postal_code": "610811278",
            "telephone_number": "815-625-0400",
            "fax_number": "815-625-2747"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MENCH",
        "first_name": "MARK",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-17",
        "last_updated": "2012-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IL",
            "license": "036061486",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "010033947",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sterling, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2012; 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.