Individual
DEANNE MARIE MARSELLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD
Contact information
Practice address
1183 DOCKLOW DR, SHILOH, IL 62221-8406
(314) 456-6809
Mailing address
1183 DOCKLOW DR, SHILOH, IL 62221-8406
(314) 456-6809
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
164.004365
IL
133V00000X
Registered Dietitian
2005037494
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1043340110
WELLCARE OF MISSOURI
MO
01
—
164.004365
STATE LICENSE
IL
01
—
721252
REGISTERED DIETITIAN
—
01
—
P01123177
RAILROAD MEDICARE
MO
Enumeration date
03/06/2007
Last updated
05/06/2026
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