Healthcare Provider Details

I. General information

NPI: 1558217323
Provider Name (Legal Business Name): MARISSA HAYLEY PAGE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/05/2026
Last Update Date: 03/05/2026
Certification Date: 03/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1408 W ARGYLE ST APT 2E
CHICAGO IL
60640-3553
US

IV. Provider business mailing address

1408 W ARGYLE ST APT 2E
CHICAGO IL
60640-3553
US

V. Phone/Fax

Practice location:
  • Phone: 312-560-0170
  • Fax:
Mailing address:
  • Phone: 312-560-0170
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number149.029685
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: