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Individual

DR. ANTONIO MARRA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
30 E 15TH ST STE 205, CHICAGO HEIGHTS, IL 60411-3476
(708) 755-4401
Mailing address
30 E 15TH ST STE 205, CHICAGO HEIGHTS, IL 60411-3476
(708) 755-4401

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
036038919
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
036038919
IL
Enumeration date
11/20/2014
Last updated
11/20/2014
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