Individual
MARYLEE BRANIECKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
LUTHERAN GENERAL HOSPITAL / PATHOLOGY DEPARTMENT, 1775 DEMPSTER STREET, PARK RIDGE, IL 60068
(847) 723-2210
Mailing address
520 E 22ND ST, LOMBARD, IL 60148-6110
(630) 874-2542
(630) 874-2642
Taxonomy
Speciality
Code
Description
License number
State
207ZD0900X
Dermatopathology (Pathology) Physician
036-085144
IL
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
036085144
IL
Other
Enumeration date
06/01/2006
Last updated
04/22/2021
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