Provider Demographics
NPI:1174082861
Name:CUTRIGHT, MARCIA (RN, LMT)
Entity type:Individual
Prefix:
First Name:MARCIA
Middle Name:
Last Name:CUTRIGHT
Suffix:
Gender:F
Credentials:RN, LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15223 CHICAGO RD
Mailing Address - Street 2:
Mailing Address - City:DOLTON
Mailing Address - State:IL
Mailing Address - Zip Code:60419-2518
Mailing Address - Country:US
Mailing Address - Phone:312-487-2990
Mailing Address - Fax:708-849-4212
Practice Address - Street 1:15223 CHICAGO RD
Practice Address - Street 2:
Practice Address - City:DOLTON
Practice Address - State:IL
Practice Address - Zip Code:60419-2518
Practice Address - Country:US
Practice Address - Phone:312-487-2990
Practice Address - Fax:708-849-4212
Is Sole Proprietor?:Yes
Enumeration Date:2019-03-13
Last Update Date:2019-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL041.251714163W00000X
IL227.010508225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
No163W00000XNursing Service ProvidersRegistered Nurse