Individual
MARIANNE B LARSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2300 CHILDRENS PLAZA, BOX 51, CHICAGO, IL 60614
(773) 880-4352
(773) 880-3374
Mailing address
2300 CHILDRENS PLAZA, BOX 51, CHICAGO, IL 60614
(773) 880-4352
(773) 880-3374
Taxonomy
Speciality
Code
Description
License number
State
2084N0402X
Neurology with Special Qualifications in Child Neurology Physician
Primary
036042065
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036042065
—
IL
Enumeration date
03/20/2006
Last updated
09/23/2011
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