Organization
MARGOT MARESKY PC
Active
Other names
Kidz PT Inc
Organization subpart
No
Provider details
NPI number
Authorized official
KARIN RICHTER (BILLING SERVICE)
(847) 769-5316
Entity
Organization
Contact information
Practice address
1673 N WOODS WAY, VERNON HILLS, IL 60061-1237
(847) 573-8992
(847) 573-8082
Mailing address
1673 N WOODS WAY, VERNON HILLS, IL 60061-1237
(847) 573-8992
(847) 573-8082
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
070005038
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01632056
BLUE SHIELD PROVIDER NUM
IL
05
—
341767342001
—
IL
Enumeration date
04/17/2007
Last updated
08/22/2008
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