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General NPI Number Information
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NPI Number | 1689104564
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Entity Type | Individual
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Provider Name | MARLON E BOHORQUEZ MD
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Gender | Male
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Dates
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Enumeration Date | 06/14/2017
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Last Update Date | 10/16/2025
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Provider Practice Location Address
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Address Line | 2222 W DIVISION ST STE 300
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City | CHICAGO
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State | IL
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Zip | 60622-3096
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Country | US
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Telephone | 773-278-1222
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Fax | 773-278-4598
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Provider Business Mailing Address
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Address Line | 2650 RIDGE AVE STE 1223
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City | EVANSTON
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State | IL
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Zip | 60201-1700
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Country | US
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Telephone |
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Fax | 773-278-4598
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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 | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 036152586
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 125070458
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License Number State | IL
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