Provider Demographics
NPI:1548014566
Name:MARINA HEALTH CARE CONSULTANTS INC
Entity type:Organization
Organization Name:MARINA HEALTH CARE CONSULTANTS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SHADI
Authorized Official - Middle Name:
Authorized Official - Last Name:MARINA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:224-234-2039
Mailing Address - Street 1:684 S BARRINGTON RD # 287
Mailing Address - Street 2:
Mailing Address - City:STREAMWOOD
Mailing Address - State:IL
Mailing Address - Zip Code:60107-1841
Mailing Address - Country:US
Mailing Address - Phone:224-234-2039
Mailing Address - Fax:847-282-4336
Practice Address - Street 1:950 S MULFORD RD.
Practice Address - Street 2:
Practice Address - City:ROCKFORD
Practice Address - State:IL
Practice Address - Zip Code:61108
Practice Address - Country:US
Practice Address - Phone:224-234-2039
Practice Address - Fax:847-282-4336
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-16
Last Update Date:2024-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty