Healthcare Provider Details

I. General information

NPI: 1316147788
Provider Name (Legal Business Name): JEFFREY JOHN MAROGIL MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/23/2007
Last Update Date: 02/11/2021
Certification Date: 02/11/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2150 PFINGSTEN RD STE 1200
GLENVIEW IL
60026
US

IV. Provider business mailing address

609 ACADEMY DR
NORTHBROOK IL
60062-2420
US

V. Phone/Fax

Practice location:
  • Phone: 847-657-1819
  • Fax: 847-657-1898
Mailing address:
  • Phone: 847-223-9494
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number036109895
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: