Marymina Respiratory Medicine, LLC

Organization Pulmonary Disease Physician · NPI 1083851174

Marymina Respiratory Medicine, LLC provides Pulmonary Disease Physician services in Washington, Illinois. Licensed in New Jersey. Registered with an NPI since 2009.

Licensed in: NJ
In the registry since: 2009

What do these letters mean?

LLC — Limited liability company: A form of business registration, not a clinical qualification.

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Practice location Address checks out

1740 Sycamore
Washington, IL 61571-9799 Not confirmed with CMS for 15 years — call before visiting
Phone: (309) 360-4879

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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Pulmonary Disease Physician (primary)	Taxonomy 207RP1001X · Licence 025MA069176 (NJ)

Record details

NPI number	1083851174
Entity type	Organization (Type 2)
Organization subpart	No
Authorized official	Ossama Ikladios — President · (309) 360-4879
NPI enumerated	January 12, 2009
Last updated in NPPES	July 10, 2011
Mailing address	1740 Sycamore, Washington, IL 61571-9799