Mark Montefolka, MD Valid NPI

Individual provider · Family Medicine Physician · Peoria Heights, IL

NPI

1114026754

Type

Individual (Type 1)

Primary specialty

Family Medicine Physician (Family Medicine)

Specialty group

Allopathic & Osteopathic Physicians

Taxonomy code

207Q00000X

License number

036110139 (IL)

Sex

Male

Sole proprietor

No

Enumerated

2006-09-21

Last updated

2007-07-09