Healthcare Provider Details

I. General information

NPI: 1871252296
Provider Name (Legal Business Name): MARATHON HEALTH, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/13/2021
Last Update Date: 08/17/2023
Certification Date: 08/17/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6300 N RIVER RD STE 100A
ROSEMONT IL
60018-4206
US

IV. Provider business mailing address

6300 N RIVER RD STE 100A
ROSEMONT IL
60018-4206
US

V. Phone/Fax

Practice location:
  • Phone: 312-421-1016
  • Fax: 847-787-7144
Mailing address:
  • Phone: 312-421-1016
  • Fax: 847-787-7144

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VIII. Authorized Official

Name: ERIN SMITH
Title or Position: PHARMACY DIRECTOR
Credential:
Phone: 816-304-1933