Mark A Fuller is a Taxi based in Peoria, IL. Mark A Fuller practices in Peoria, IL. The NPI Number for Mark A Fuller is 1417470147 and holds a License No. (Illinois).
The current practice location address for Mark A Fuller is 2215 W Willow Knolls Drive, Peoria, IL and can be reached out via phone at 217-330-0928.
Location: 2215 W Willow Knolls Drive, Peoria, IL, 61614-1446
Provider Profile Details
NPI Number
1417470147
Provider Name
Mark A Fuller
Credential
Provider Entity Type
Individual
Gender
Male
Address
2215 W Willow Knolls Drive, Peoria, IL, 61614-1446
Phone Number
217-330-0928
Fax Number
Provider Enumeration Date
07/25/2017
Last Update Date
03/09/2024
Provider's Legacy Identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 82-2237856 | 05 | IL |
Provider Business Practice Location Address Details
Address
2215 W Willow Knolls Drive
City
State
Zip
61614-1446
Phone Number
217-330-0928
Fax Number
Provider Business Mailing Address Details
Address
2215 W Willow Knolls Drive
City
State
Zip
61614-1446
Phone Number
217-330-0928
Fax Number
Provider's Taxonomy Details 1
Type
Transportation Services
Classification
Taxi
Speciality
-
Taxonomy
License No.
()
Definition
A land commercial vehicle used for the transporting of persons in non-emergency situations. The vehicle meets local, county or state regulations set forth by the jurisdictions where it is located.
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