person
Dr. Mark Edwin Carlson, MD
Specialist in Rockford, Illinois
NPI 1790741049

Mark Edwin Carlson is a Specialist based in Rockford, IL. Mark Edwin Carlson practices in Rockford, IL and has the professional credentials of MD. The NPI Number for Mark Edwin Carlson is 1790741049 and holds a License No. 036-073115 (Illinois).

The current practice location address for Mark Edwin Carlson is 1848 Daimler Rd, Rockford, IL and can be reached out via phone at 815-398-9100 and via fax at 815-986-6770.

Location: 1848 Daimler Rd, Rockford, IL, 61112-1019
person
Provider Profile Details
NPI Number
1790741049
Provider Name
Mark Edwin Carlson
Credential
MD
Provider Entity Type
Individual
Gender
Male
Address
1848 Daimler Rd, Rockford, IL, 61112-1019
Phone Number
815-398-9100
Fax Number
815-986-6770
Provider Enumeration Date
04/25/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
K52428 01 IL MEDICARE PTAN
36073065 05 IL
institution
Provider Business Practice Location Address Details
Address
1848 Daimler Rd
City
State
Zip
61112-1019
Phone Number
815-398-9100
Fax Number
815-986-6770
person
Provider Business Mailing Address Details
Address
1848 Daimler Rd
City
State
Zip
61112-1019
Phone Number
815-398-9100
Fax Number
815-986-6770
person
Provider's Taxonomy Details 1
Type
Other Service Providers
Classification
Specialist
Speciality
-
Taxonomy
License No.
036-073115 (Illinois)
Definition
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.
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