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Individual
MICHAEL ROGER MARINO
Active
Individual
MICHAEL ROGER MARINO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
085009976
IL
363AS0400X
Surgical Physician Assistant
Primary
085009976
IL
Other
Enumeration date
08/09/2023
Last updated
12/23/2025
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