Individual
TETYANA MARSHALL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2650 RIDGE AVE, DEPARTMENT OF ANESTHESIA, EVANSTON, IL 60201-1718
(847) 570-2760
(847) 570-2921
Mailing address
150 HARVESTER DR STE 300, BURR RIDGE, IL 60527-5965
(888) 824-0200
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
036.173099
IL
207L00000X
Anesthesiology Physician
036173099
IL
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
036.173099
IL
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
036173099
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
659115-011-00001
AETNA
—
Enumeration date
03/20/2020
Last updated
05/08/2026
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