Dustin Marley, PA-C
Physician Assistant in Chicago, IL. Individual provider (NPI-1).
NPI number1114335353
StatusActive
Last updated in NPPESNov 19, 2024
Details
- NPI
- 1114335353
- Entity type
- Individual (NPI-1)
- Name
- Dustin Marley
- Credential
- PA-C
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Jul 31, 2014
- Certification date
- Nov 19, 2024
- Last updated
- Nov 19, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363A00000X | Physician Assistant | 085010476 | IL | Yes |
| 363AM0700X | Physician Assistant, Medical | – | – |
Practice location
676 N Saint Clair St Ste 940Chicago, IL 60611-2945
Phone 312-926-8358 · Fax 312-926-9630
Mailing address
676 N Saint Clair St Ste 940Chicago, IL 60611-2945
Phone 312-926-8358 · Fax 312-926-9630
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