Individual
MARK MARCELLO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMT
Contact information
Practice address
143 OLD FARM LN, CARPENTERSVILLE, IL 60110-1461
(847) 224-5108
Mailing address
143 OLD FARM LN, CARPENTERSVILLE, IL 60110-1461
(847) 224-5108
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
057.001111
IL
225700000X
Massage Therapist
227.009599
IL
Other
Enumeration date
02/22/2009
Last updated
03/02/2018
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