MIRELLA MARZOCCHI (NPI# 1720147283) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1720147283 |
| Entity Type | Individual |
| Full Name | MIRELLA MARZOCCHI |
| Credential | MD |
| Practice Address |
2650 Ridge Ave Walgreen Buildling, Room 1505 Evanston IL 60201-1718 |
| Mailing Address |
2650 Ridge Ave Evanston Hospital Evanston IL 60201-1718 |
| Practice Telephone | 8475702033 |
| Practice Fax Number | 8475700231 |
| Mailing Telephone | 8475701206 |
| Mailing Fax Number | 8475701248 |
| Enumeration Date | 2006-12-08 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2080N0001X |
Pediatrics Specialization: Neonatal-Perinatal Medicine |
IL | Allopathic & Osteopathic Physicians |
| Street Address |
2650 RIDGE AVE WALGREEN BUILDLING, ROOM 1505 |
| City | EVANSTON |
| State | IL |
| Zip Code | 60201-1718 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669476545 | Steven C Smart | Internal Medicine | 2650 Ridge Ave, Evanston, IL 60201-1718 | 2005-06-09 |
| 1609477744 | Nicole Jeanine Strode | Nurse Anesthetist, Certified Registered | 2650 Ridge Ave, Evanston, IL 60201-1700 | 2020-11-04 |
| 1609475243 | Fredrich Francis Raz | Nurse Anesthetist, Certified Registered | 2650 Ridge Ave, Evanston, IL 60201-1700 | 2020-10-24 |
| 1548869209 | Ross Phillips | Nurse Anesthetist, Certified Registered | 2650 Ridge Ave, Evanston, IL 60201-1700 | 2020-10-22 |
| 1760081673 | Lauren Elizabeth Todorova | Dietitian, Registered | 2650 Ridge Ave, Evanston, IL 60201-1700 | 2020-10-21 |
| 1245839364 | Christine B Lawlor | Nurse Practitioner | 2650 Ridge Ave, Evanston, IL 60201-1700 | 2020-10-20 |
| 1386242956 | Jessica Elaine Rogers | Nurse Anesthetist, Certified Registered | 2650 Ridge Ave, Evanston, IL 60201-1700 | 2020-10-15 |
| 1376141226 | Amanda Hemple | Registered Nurse | 2650 Ridge Ave, Evanston, IL 60201-1700 | 2020-10-13 |
| 1710584297 | Natalia W Izquierdo | Nurse Anesthetist, Certified Registered | 2650 Ridge Ave, Evanston, IL 60201-1700 | 2020-10-07 |
| 1558975078 | Lauren Grandi | Nurse Practitioner | 2650 Ridge Ave, Evanston, IL 60201-1700 | 2020-09-02 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356962898 | Sebastian Andres Cruz | Internal Medicine | Northshore University Healthsystem, Off of Acad Affairs, 2650 Ridge Ave., Suite 1304, Evanston, IL 60201 | 2020-05-06 |
| 1053970442 | Wade Gilman | Family Medicine | 1650 Ridge Ave, Ste 1304, Evanston, IL 60201 | 2019-06-10 |
| 1922577949 | Elizabeth Wilton Therapy, LLC | Counselor | 2901a Central St Ste 3, Evanston, IL 60201 | 2018-11-20 |
| 1952887812 | Sg Wellness LLC | Clinic/Center | 3008 Central Street, Evanston, IL 60201 | 2018-07-13 |
| 1689169591 | Michael Kert Zijlstra | Internal Medicine | Northshore University Healthsystem Office of Academic, Affairs 2650 Ridge Ave, Suite 1304, Evanston, IL 60201 | 2018-06-25 |
| 1982199725 | Elizabeth Hannah Lees | Internal Medicine | Northshore University Healthsystem Office of Academic A, 2650 Ridge Ave Suite 1304, Evanston, IL 60201 | 2018-06-25 |
| 1730674565 | Ashley Elizabeth Aller | Internal Medicine | Northshore University Healthsystem, Office Acad Affairs, 2650 Ridge Ave., Suite 1304, Evanston, IL 60201 | 2018-06-25 |
| 1669967683 | Ayush N Shah | Internal Medicine | 2650 Ridge Ave Ste 5315, Evanston, IL 60201 | 2018-06-22 |
| 1811481062 | Jeffrey D. Brow | Internal Medicine | 2650 Ridge Ave Rm 5315, Evanston, IL 60201 | 2018-06-20 |
| 1831687250 | Michael Patrick Murphy | Radiology | 807 Davis St. Unit 707, Evanston, IL 60201 | 2018-05-01 |
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| Taxonomy Code | 2080N0001X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| Specialization | Neonatal-Perinatal Medicine |
| A pediatrician who is the principal care provider for sick newborn infants. Clinical expertise is used for direct patient care and for consulting with obstetrical colleagues to plan for the care of mothers who have high-risk pregnancies. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265845366 | Patrick Daniel Hughes | Pediatrics | 2650 Ridge Ave, Evanston, IL 60201-1700 | 2014-06-05 |
| 1326467069 | Kendall Ulbrich | Pediatrics | 2650 Ridge Ave, Evanston, IL 60201-1700 | 2014-04-09 |
| 1831324110 | Marin Mcgee Arnolds | Pediatrics | 2650 Ridge Ave, Walgreen 1505, Evanston, IL 60201-1718 | 2009-05-15 |
| 1548326507 | Brandy L Frost | Pediatrics | 2650 Ridge Ave, Walgreens Building, Suite 1505, Evanston, IL 60201-1718 | 2006-12-27 |
| 1568544658 | Matthew Derrick | Pediatrics | 2650 Ridge Ave., Division of Neonatology, Walgreen Bldg Rm 1505, Evanston, IL 60201-1718 | 2006-10-19 |
| 1861574949 | Michael S Caplan | Pediatrics | 2650 Ridge Ave, Division of Neonatology, Walgreen Bldg Rm 1505, Evanston, IL 60201-1718 | 2006-10-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043767841 | Gail Sharon Haiken | Pediatrics | 5303 Regents Park Rd, Rockford, IL 61107-5092 | 2016-09-08 |
| 1871910976 | Jessica Lahn Chiang | Pediatrics | 1775 Dempster St # 54, Park Ridge, IL 60068-1143 | 2014-03-26 |
| 1669806667 | Ricardo Tomas Rosenkranz | Pediatrics | 1200 N Lake Shore Dr, Apt. 904, Chicago, IL 60610-2370 | 2013-08-26 |
| 1063845626 | Kala Sukerkar | Pediatrics | 2406 Indian Ridge Dr, Glenview, IL 60026-1030 | 2013-08-18 |
| 1407194780 | Well Baby Care PC | Pediatrics | 1185-87 Dundee Avenue, Suite A-2, Elgin, IL 60120 | 2013-01-22 |
| 1275898116 | Pele Boutrous Dina | Pediatrics | 415 N 9th St # 4w16, Springfield, IL 62702 | 2012-07-06 |
| 1447516257 | John Vincent Hartline | Pediatrics | 1259 Prestwick Ln, Itasca, IL 60143-1975 | 2012-04-05 |
| 1780979302 | Kelly Nelson Kelly | Pediatrics | 5841 S Maryland Ave # Mc6060, Chicago, IL 60637-1447 | 2011-06-11 |
| 1255623997 | Venkata Sasidhar Majjiga | Pediatrics | 301 N 8th Street, Siu School of Medicine, Pediatrics, Room 3a169, Springfield, IL 62794 | 2011-05-13 |
| 1700187531 | Ursula Patricia Colareta Ugarte | Pediatrics | 1444 Carol St Apt A, Park Ridge, IL 60068-1290 | 2010-11-10 |
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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.