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Search › Illinois › 364S00000X

Marvis Custer

NPI 1215237987 · on the registry since 2010

Practice

Address
1701 E College Ave
Bloomington, IL 61704
Phone
(309) 662-3000
Fax
(309) 664-3026
Organisation at this address
St Joseph Medical Center
St. Joseph Medical Center
Carle Foundation Hospital
Carle Foundation Hospital
Osf Multi-Specialty Group
Inferred from a shared address, not stated in the registry.
Clinicians at this address
61

Registry record

Primary taxonomy
364S00000X
364S00000X
Licence states on file
IL
From the registry's licence fields, which are often incomplete.
Sex
Female
Record last updated
2010-10-28

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Illinois