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Individual

MARLENE K HENZE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
1221 N HIGHLAND AVE, AURORA, IL 60506-1404
(630) 801-2589
Mailing address
1870 W GALENA BLVD, AURORA, IL 60506-4356
(630) 859-6800

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
036093007
IL
208M00000X
Hospitalist Physician
Primary
036093007
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
036093007
IL
01
0451514334
BLUE CROSS BLUE SHIELD
IL
01
3227787
BLUE CROSS BLUE SHIELD
IL
Enumeration date
11/17/2006
Last updated
11/13/2014
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