Healthcare Provider Details

I. General information

NPI: 1023713401
Provider Name (Legal Business Name): ASHLEY ELIZABETH MARENYI FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/04/2023
Last Update Date: 05/07/2024
Certification Date: 05/07/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

160 E ILLINOIS ST
CHICAGO IL
60611-5426
US

IV. Provider business mailing address

160 E ILLINOIS ST
CHICAGO IL
60611-5426
US

V. Phone/Fax

Practice location:
  • Phone: 312-477-2400
  • Fax:
Mailing address:
  • Phone: 312-477-2400
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number209027954
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code163WX0200X
TaxonomyOncology Registered Nurse
License Number041443130
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: