Healthcare Provider Details

I. General information

NPI: 1063217172
Provider Name (Legal Business Name): MARATONICA MARBIBI RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/14/2025
Last Update Date: 02/14/2025
Certification Date: 02/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2000 OGDEN AVE
AURORA IL
60504-5893
US

IV. Provider business mailing address

706 S WEBER RD UNIT 118
ROMEOVILLE IL
60446-3060
US

V. Phone/Fax

Practice location:
  • Phone: 630-978-4810
  • Fax:
Mailing address:
  • Phone: 706-941-6767
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WE0003X
TaxonomyEmergency Registered Nurse
License Number041539758
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: