Provider Demographics
NPI:1164682555
Name:FLUTURE, MARISSA (PT)
Entity Type:Individual
Prefix:
First Name:MARISSA
Middle Name:
Last Name:FLUTURE
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:MARISSA
Other - Middle Name:
Other - Last Name:BOLSEN SVALENKA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1929 SPRINGSIDE DR
Mailing Address - Street 2:
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60565-4206
Mailing Address - Country:US
Mailing Address - Phone:312-951-8200
Mailing Address - Fax:
Practice Address - Street 1:712 N DEARBORN ST
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60654-3846
Practice Address - Country:US
Practice Address - Phone:312-951-8200
Practice Address - Fax:312-268-5434
Is Sole Proprietor?:No
Enumeration Date:2008-06-10
Last Update Date:2022-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL070-014205225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist