MEDICARE: GINA MARIE MARCIN APRN FPA, CNM, LAC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	171100000X	Acupuncturist	198.000527	IL
2	367A00000X	Advanced Practice Midwife	277.005403	IL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	277.005403	OTHER	IL	FULL PRACTICE AUTHORITY APRN

General Provider Information

NPI Number	:	1205261682
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GINA MARIE MARCIN APRN FPA, CNM, LAC

Provider Business Mailing Address
First Line	:	1051 W RAND RD STE 101
Second Line	:
City	:	ARLINGTON HEIGHTS
State	:	IL
Zip	:	60004-2315
Country	:	US
Telephone Number	:	847-221-4900
Fax Number	:	847-221-4996

Provider Business Practice Location Address
First Line	:	1051 W RAND RD STE 101
Second Line	:
City	:	ARLINGTON HEIGHTS
State	:	IL
Zip	:	60004-2315
Country	:	US
Telephone Number	:	847-221-4900
Fax Number	:	847-221-4996

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/04/2013
Last Update Date	:	04/07/2026

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