Provider Demographics
NPI:1225110471
Name:MARGIOTTA, MARC LOUIS (DN)
Entity Type:Individual
Prefix:DR
First Name:MARC
Middle Name:LOUIS
Last Name:MARGIOTTA
Suffix:
Gender:M
Credentials:DN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:500 N MICHIGAN AVE
Mailing Address - Street 2:SUITE 450
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60611-3777
Mailing Address - Country:US
Mailing Address - Phone:312-276-1212
Mailing Address - Fax:312-276-1213
Practice Address - Street 1:500 N MICHIGAN AVE
Practice Address - Street 2:SUITE 450
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60611-3777
Practice Address - Country:US
Practice Address - Phone:312-276-1212
Practice Address - Fax:312-276-1213
Is Sole Proprietor?:No
Enumeration Date:2006-10-19
Last Update Date:2013-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL181000161172P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172P00000XOther Service ProvidersNaprapath