| Mary L Marshall, APN | |
|
1340 Charles St, Suite 300, Rockford, IL 61104-2200 | |
| (779) 696-5888 | |
| Not Available |
| Full Name | Mary L Marshall |
|---|---|
| Gender | Female |
| Speciality | Nurse Practitioner |
| Experience | 10 Years |
| Location | 1340 Charles St, Rockford, Illinois |
| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1770030801 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 163W00000X | Registered Nurse | 041343459 (Illinois) | Secondary |
| 363L00000X | Nurse Practitioner | 209-014991 (Illinois) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Osf Saint Anthony Medical Center | Rockford, IL | Hospital |
| Osf Saint Paul Medical Center | Mendota, IL | Hospital |
| Ottawa Regional Hospital Dba Osf Saint Elizabeth Mdl Ctr | Ottawa, IL | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Osf Multi-specialty Group | 3678889789 | 1848 |
| Entity Name | Osf Multi-specialty Group |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1922445527 PECOS PAC ID: 3678889789 Enrollment ID: O20150904000279 |
| Mailing Address | Practice Location Address |
|---|---|
| Mary L Marshall, APN Po Box 1567, Rockford, IL 61110-0067 Ph: () - | Mary L Marshall, APN 1340 Charles St, Suite 300, Rockford, IL 61104-2200 Ph: (779) 696-5888 |
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