Dr Marny Lee Fetzer, MD in Evanston, IL - Medicare Emergency Medicine

Dr Marny Lee Fetzer, MD is a medicare enrolled "Emergency Medicine - Hospice And Palliative Medicine" physician in Evanston, Illinois. Her current practice location is 2650 Ridge Ave, Evanston, Illinois. You can reach out to her office (for appointments etc.) via phone at (847) 503-4222.

Dr Marny Lee Fetzer is licensed to practice in Illinois (license number 036115628) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1982643730.

Contact Information

	Dr Marny Lee Fetzer, MD
	2650 Ridge Ave, Evanston, IL 60201-1700
	(847) 503-4222
	Not Available

Map and Direction

Physician's Profile

Full Name	Dr Marny Lee Fetzer
Gender	Female
Speciality	Emergency Medicine - Hospice And Palliative Medicine
Location	2650 Ridge Ave, Evanston, Illinois
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1982643730
Provider Enumeration Date: 06/06/2006
Last Update Date: 08/26/2025

Medicare PECOS Information:

PECOS PAC ID: 9133122880
Enrollment ID: I20060817000616

Medical Identifiers

Medical identifiers for Dr Marny Lee Fetzer such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1982643730	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
207PH0002X	Emergency Medicine - Hospice And Palliative Medicine	036115628 (Illinois)	Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Dr Marny Lee Fetzer allows following entities to bill medicare on her behalf.

Entity Name	Advocate Health And Hospitals Corporation
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1700824455 PECOS PAC ID: 7810800935 Enrollment ID: O20031106000064

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Marny Lee Fetzer is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Dr Marny Lee Fetzer, MD 2650 Ridge Ave Ste 1223, Evanston, IL 60201-1700 Ph: (847) 570-2040	Dr Marny Lee Fetzer, MD 2650 Ridge Ave, Evanston, IL 60201-1700 Ph: (847) 503-4222

Reviews and Comments

Emergency Medicine Doctors in Evanston, IL

Michael T. Gillam, M.D. Emergency Medicine Medicare: Not Enrolled in Medicare Practice Location: 2650 Ridge Ave, Emergency Medicine Rm G909, Evanston, IL 60201 Phone: 847-570-2114 Fax: 847-570-1223
Evan G Laskaris, MD Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 2650 Ridge Ave, Division Of Emergency Medicine, Evanston, IL 60201 Phone: 847-570-2114 Fax: 847-570-1223
Irene C. Yao, MD Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 2650 Ridge Ave, Evanston, IL 60201 Phone: 847-570-2114
Korie Lynne Zink, MD, MS Emergency Medicine Medicare: Medicare Enrolled Practice Location: 2650 Ridge Ave, Evanston, IL 60201 Phone: 847-570-2114 Fax: 847-570-1223
Yudith Diaz Baez, MD Emergency Medicine Medicare: Medicare Enrolled Practice Location: 2650 Ridge Ave, Evanston, IL 60201 Phone: 847-570-2114 Fax: 847-570-1223
Isaac Kolawole Agboola, MD Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 2650 Ridge Ave, Evanston, IL 60201 Phone: 847-570-2114 Fax: 847-570-1223
Wilber P. Yep, MD Emergency Medicine Medicare: Medicare Enrolled Practice Location: 2650 Ridge Ave, Emergency Medicine Rm G909, Evanston, IL 60201 Phone: 847-570-2114 Fax: 847-570-1223

Dr Marny Lee Fetzer, MD - Medicare Emergency Medicine in Evanston, IL