Healthcare Provider Details

I. General information

NPI: 1013864131
Provider Name (Legal Business Name): MARINA VESLIEVSKI
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/16/2026
Last Update Date: 03/16/2026
Certification Date: 03/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10 OAKBROOK CENTER MALL
OAK BROOK IL
60523-1810
US

IV. Provider business mailing address

1004 CHARLTON LN
NAPERVILLE IL
60563-4169
US

V. Phone/Fax

Practice location:
  • Phone: 331-317-9500
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number209034911
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: