Individual
MARISELA VARELA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
90 W 86TH AVE, MERRILLVILLE, IN 46410-7086
(219) 791-1555
(219) 791-1560
Mailing address
120 W 22ND ST STE 200, OAK BROOK, IL 60523-1563
(630) 575-5000
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
01065202A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200901480
—
IN
05
—
269477800
—
FL
01
—
43239
BCBS
FL
Enumeration date
09/06/2005
Last updated
06/01/2022
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