Provider Demographics
NPI:1366621393
Name:CHERCHI, MARCELLO (MD, PHD)
Entity type:Individual
Prefix:DR
First Name:MARCELLO
Middle Name:
Last Name:CHERCHI
Suffix:
Gender:M
Credentials:MD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:645 N MICHIGAN AVE
Mailing Address - Street 2:SUITE 410
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60611-2826
Mailing Address - Country:US
Mailing Address - Phone:312-274-0197
Mailing Address - Fax:312-376-8707
Practice Address - Street 1:645 N MICHIGAN AVE
Practice Address - Street 2:SUITE 410
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60611-2826
Practice Address - Country:US
Practice Address - Phone:312-274-0197
Practice Address - Fax:312-376-8707
Is Sole Proprietor?:No
Enumeration Date:2007-10-26
Last Update Date:2009-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL0361144652084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology