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General NPI Number Information
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NPI Number | 1568127629
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Entity Type | Individual
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Provider Name | MARY-KATHERINE MARSHALL
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Gender | Female
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Dates
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Enumeration Date | 11/03/2021
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Last Update Date | 05/16/2025
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Provider Practice Location Address
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Address Line | 5721 S MARYLAND AVE
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City | CHICAGO
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State | IL
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Zip | 60637-1425
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Country | US
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Telephone | 888-824-0200
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Fax |
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Provider Business Mailing Address
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Address Line | 1436 W HENDERSON ST APT 2
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City | CHICAGO
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State | IL
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Zip | 60657-2170
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Country | US
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Telephone | 630-802-3752
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0200X
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Taxonomy Name | Pediatric Nurse Practitioner
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License Number | 318088
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License Number State | AZ
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Taxonomy #2
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Taxonomy Code | 363LP0200X
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Taxonomy Name | Pediatric Nurse Practitioner
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License Number | 209.023794
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License Number State | IL
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