Mark Alan Regnier, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

036097453 Issued in IL

Practice address

1830 Mediterranean Dr
Sycamore, IL 60178-3144

Phone

(815) 899-0001

Fax

(815) 899-0002

NPI assigned

Jul 7, 2005

Last updated

Jul 6, 2011By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Genesis Pediatric Medicine, LLC

  • Pediatrics Physician
  • Sycamore, IL
  • NPI 1912295494
  NPD (past) Authorized official

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

{
    "created_epoch": "1120694400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1309910400000",
    "number": "1851398663",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1830 MEDITERRANEAN DR",
            "city": "SYCAMORE",
            "state": "IL",
            "postal_code": "601783144",
            "telephone_number": "815-899-0001",
            "fax_number": "815-899-0002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1830 MEDITERRANEAN DR",
            "city": "SYCAMORE",
            "state": "IL",
            "postal_code": "601783144",
            "telephone_number": "815-899-0001",
            "fax_number": "815-899-0002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REGNIER",
        "first_name": "MARK",
        "middle_name": "ALAN",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-07-07",
        "last_updated": "2011-07-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IL",
            "license": "036097453",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036097453",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Rebound Therapy Center PC
• Rebound Therapy Ceter
• Amulya Reddy, D.O.
• Tesia Reed, OD
• Reflection Is Healing Counseling Services
• Kaitlyn Madonna Reif, DPT
• Donna Ann Rennard, LCPC
• Michael Dean Reser, P.T.
• Sonya Brandon Ristine, FNP-BC
• Andi Marie Rivers, FNP-BC

• Pediatrics Physician in Sycamore, IL
• Providers in Sycamore, IL by specialty
• Pediatrics Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 6, 2011; 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.