Individual
DR. RYAN MARCELINO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
225 E CHICAGO AVE, CHICAGO, IL 60611
(732) 406-5538
Mailing address
225 E CHICAGO AVE, BOX 19, CHICAGO, IL 60611
(732) 406-5538
Taxonomy
Speciality
Code
Description
License number
State
207LP3000X
Pediatric Anesthesiology Physician
Primary
036140786
IL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
06/17/2010
Last updated
07/19/2019
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