MARLENE K HENZE MD PC (NPI# 1437462975) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1437462975 |
| Entity Type | Organization |
| Organization Name | MARLENE K HENZE MD PC |
| Practice Address |
151 W High St Morris IL 60450-1407 |
| Mailing Address |
35 E Willow St Ste B Coal City IL 60416-1869 |
| Practice Telephone | 8154161331 |
| Practice Fax Number | 8156343188 |
| Mailing Telephone | 8156343048 |
| Mailing Fax Number | 8156343188 |
| Enumeration Date | 2010-07-26 |
| Last Update Date | 2011-09-20 |
| Authorized Official Name | MARLENE K HENZE (PRESIDENT) |
| Authorized Official Telephone | 8154161331 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QH0100X |
Clinic/Center Specialization: Health Service |
036093007 | IL | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| ILLINOIS MEDICAID | 036093007 | 01 | |
| IL | BCBS OF IL | 3227787 | 01 |
| IL | MEDICARE RAILROAD | 080181425 | 01 |
| Street Address |
151 W HIGH ST |
| City | MORRIS |
| State | IL |
| Zip Code | 60450-1407 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548269061 | Il Bong Kim | Surgery | 151 W High St, Morris, IL 60450-1407 | 2005-07-18 |
| 1639348881 | Athar Muhammad Saeed | Internal Medicine | 151 W High St, Lower Level, Morris, IL 60450-1407 | 2008-02-21 |
| 1053536078 | Muhammad R Marwali | Internal Medicine | 151 W High St, Morris, IL 60450 | 2007-04-16 |
| 1972694263 | Van Loudon Hicks | Family Medicine | 151 W High St, Morris, IL 60450-1407 | 2006-09-28 |
| 1053393439 | Syed M Ahmed | Internal Medicine | 151 W High St, Lower Level, Morris, IL 60450-1407 | 2005-11-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376144691 | Jessica Kubinski | Occupational Therapist | 1051 W, Us-6, Morris, IL 60450 | 2020-11-03 |
| 1922646652 | Anna Doherty | Counselor | Crossroads Counseling Services, 1802 N Division St Suite 509, Morris, IL 60450 | 2019-12-12 |
| 1003353764 | Crossroads Counseling Services, LLC | Community/Behavioral Health | 1802 N Division Street, Suite 509, Morris, IL 60450 | 2017-01-19 |
| 1780128249 | Lori Lynn Peterson | Nurse Practitioner | 8805 N Tabler Road, Health & Wellness Clinic, Morris, IL 60450 | 2016-12-18 |
| 1639613532 | Jodi Lynn Valencia | Licensed Practical Nurse | 114 E. Benton St., Morris, IL 60450 | 2016-12-12 |
| 1184001844 | Ashish G. Suthar | Pharmacist | 1600 West Route 6, Morris, IL 60450 | 2015-05-01 |
| 1255690574 | Tammy S. Zweeres | Nurse Practitioner | 936 W. U.S. Route 6, Morris, IL 60450 | 2012-05-07 |
| 1952682742 | Marie E Monhardt | Nurse Practitioner | 801 So Washington Str, Naperville, IL 60450 | 2011-09-07 |
| 1093024200 | Diane Marie Zuelke | Nurse Practitioner | 1802 N Division St Ste 703, Morris, IL 60450 | 2010-10-05 |
| 1063669182 | Athletic & Therapeutic Institute of Naperville, LLC | Physical Therapist | 201 East U.S. Route 6, Morris, IL 60450 | 2008-08-20 |
| Find all providers in zip 60450 | ||||
| Taxonomy Code | 261QH0100X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Health Service |
| Definition to come... |
| Notes: [7/1/2006: modified title] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376658658 | Morris Hospital | Clinic/Center | 1345 Edwards St Ste 1, Morris, IL 60450 | 2006-08-20 |
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| 1346708815 | Erin Conway, Psyd, PC | Clinic/Center | 444 S Rand Rd Ste 214, Lake Zurich, IL 60047-2307 | 2019-03-04 |
| 1891252078 | Essence Healthcare Services LLC | Clinic/Center | 10449 Venice Ln, Orland Park, IL 60467-8218 | 2019-02-25 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.