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Contact Information

MARK S DOLZ, DO
1600 W WALNUT
PASSAVANT AREA HOSPITAL - LABORATORY
JACKSONVILLE, IL62650
 Phone: 217-245-9541
 Fax: 217-479-5648
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Anatomic Pathology & Clinical Pathology

207ZP0102X 22 Physician/Pathology
Indicates primary specialty

NPI Profile & details for MARK S DOLZ · (Male)

NPI # 1104833631
Status Active
Credentials DO (Doctor of Osteopathic)
Entity Individual
Enumeration date 08/01/2006
Last updated 06/06/2025 - About 12 months ago
Sole proprietor 1 No
Identifiers
  • IL License # 036094413
  • IL Medicaid 0360944131
Hospital affiliation(s)
  • DOCTORS HOSPITAL AT RENAISSANCE - (Acute Care)
    5501 SOUTH MCCOLL
    EDINBURG, TX 78539
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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