Individual provider · NPI-1

Melisa Marotta, PNP

Nurse Practitioner, Pediatrics · Berwyn, IL

NPI number1366817223
StatusActive
Last updated in NPPESDec 23, 2015

Details

NPI
1366817223
Entity type
Individual (NPI-1)
Name
Melisa Marotta
Credential
PNP
Sex
Female
Sole proprietor
No
Enumeration date
Dec 3, 2015
Last updated
Dec 23, 2015

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
363LP0200X Nurse Practitioner, Pediatrics209012848ILYes

Practice location

6545 Cermak Rd
Berwyn, IL 60402-2313

Phone 708-788-0077

Mailing address

2842 Mayfair Ave
Westchester, IL 60154-5009

Phone 708-289-2628

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