Healthcare Provider Details

I. General information

NPI: 1528982105
Provider Name (Legal Business Name): MEGAN PATRICIA MARSHALL DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/06/2026
Last Update Date: 08/06/2026
Certification Date: 08/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2101 E 71ST ST
CHICAGO IL
60649-2143
US

IV. Provider business mailing address

343 W WOLF POINT PLZ UNIT 801
CHICAGO IL
60654-8899
US

V. Phone/Fax

Practice location:
  • Phone: 773-241-7000
  • Fax:
Mailing address:
  • Phone: 585-978-4326
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number019037435
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: