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General NPI Number Information
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NPI Number | 1427053552
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Entity Type | Organization
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Legal Business Name | MARQUETTE RADIOLOGY ASSOCIATES LLC
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Dates
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Enumeration Date | 06/16/2005
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 2701 W 68TH ST
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City | CHICAGO
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State | IL
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Zip | 60629-1813
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Country | US
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Telephone | 773-884-1662
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Fax | 314-631-4491
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Provider Business Mailing Address
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Address Line | PO BOX 2153
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City | BEDFORD PARK
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State | IL
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Zip | 60499-2153
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Country | US
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Telephone | 800-354-1088
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Fax | 314-631-4491
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Authorized Official
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Title or Position | PRESIDENT/PROVIDER
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Name | DR. FRANK M MARMO
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Credential | MD
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Telephone | 800-354-1088
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number |
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License Number State | IL
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