MEDICARE: KATHERINE E MARCHESE APN

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	363LF0000X	Family Nurse Practitioner	209.007486	IL
2	163W00000X	Registered Nurse	041-156312	IL
3	363LF0000X	Family Nurse Practitioner	209002628	IL
4	364S00000X	Clinical Nurse Specialist	209-002628	IL
5	363L00000X	Nurse Practitioner	209007486	IL

General Provider Information

NPI Number	:	1972663672
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KATHERINE E MARCHESE APN

Provider Business Mailing Address
First Line	:	2180 PFINGSTEN RD STE 3000
Second Line	:
City	:	GLENVIEW
State	:	IL
Zip	:	60026-1340
Country	:	US
Telephone Number	:	847-503-3000
Fax Number	:	847-503-3500

Provider Business Practice Location Address
First Line	:	2180 PFINGSTEN RD STE 3000
Second Line	:
City	:	GLENVIEW
State	:	IL
Zip	:	60026-1340
Country	:	US
Telephone Number	:	847-503-3000
Fax Number	:	847-503-3500

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

Provider Enumeration Date	:	12/11/2006
Last Update Date	:	06/29/2021

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