MEDICARE: MARGARET WELDON MARQUARDT M.ED./ED.S., NCSP

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	103TS0200X	School Psychologist	2320661	IL

General Provider Information

NPI Number	:	1821580580
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARGARET WELDON MARQUARDT M.ED./ED.S., NCSP

Provider Business Mailing Address
First Line	:	850 HIGHLAND GROVE DR
Second Line	:
City	:	BUFFALO GROVE
State	:	IL
Zip	:	60089-1549
Country	:	US
Telephone Number	:	847-955-3600
Fax Number	:

Provider Business Practice Location Address
First Line	:	850 HIGHLAND GROVE DR
Second Line	:
City	:	BUFFALO GROVE
State	:	IL
Zip	:	60089-1549
Country	:	US
Telephone Number	:	847-955-3600
Fax Number	:

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

Provider Enumeration Date	:	05/30/2018
Last Update Date	:	05/30/2018

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