Organization
ANTONIO MARRA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ANTONIO MARRA M.D. (OWNER)
(708) 755-4401
Entity
Organization
Contact information
Practice address
30 E 15TH ST STE 205, CHICAGO HEIGHTS, IL 60411-3476
(708) 755-4401
Mailing address
30 E 15TH ST STE 205, CHICAGO HEIGHTS, IL 60411-3476
(708) 755-4401
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
036038919
IL
Other
Enumeration date
11/05/2014
Last updated
11/05/2014
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