Healthcare Provider Details

I. General information

NPI: 1720998651
Provider Name (Legal Business Name): ELISE MARCHIONE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/11/2026
Last Update Date: 09/11/2026
Certification Date: 09/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14700 LINCOLN ST
OAK PARK MI
48237-1366
US

IV. Provider business mailing address

14501 TALBOT ST
OAK PARK MI
48237-1160
US

V. Phone/Fax

Practice location:
  • Phone: 248-837-8900
  • Fax:
Mailing address:
  • Phone: 248-837-8000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number7101004947
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: