Healthcare Provider Details

I. General information

NPI: 1700852571
Provider Name (Legal Business Name): MARSHALL S SPARBERG M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 02/23/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

676 N SAINT CLAIR ST SUITE 1525
CHICAGO IL
60611-2927
US

IV. Provider business mailing address

1730 PARK ST SUITE 101
NAPERVILLE IL
60563-2688
US

V. Phone/Fax

Practice location:
  • Phone: 312-944-7080
  • Fax: 312-266-0478
Mailing address:
  • Phone: 630-718-0200
  • Fax: 630-718-0900

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License Number
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: