Provider Demographics
NPI:1235738899
Name:MARSHALL, CHAVIER (CNA)
Entity Type:Individual
Prefix:
First Name:CHAVIER
Middle Name:
Last Name:MARSHALL
Suffix:
Gender:F
Credentials:CNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:303 S SCOTTSWOOD DR
Mailing Address - Street 2:
Mailing Address - City:URBANA
Mailing Address - State:IL
Mailing Address - Zip Code:61802-4550
Mailing Address - Country:US
Mailing Address - Phone:217-722-7780
Mailing Address - Fax:
Practice Address - Street 1:303 S SCOTTSWOOD DR
Practice Address - Street 2:
Practice Address - City:URBANA
Practice Address - State:IL
Practice Address - Zip Code:61802-4550
Practice Address - Country:US
Practice Address - Phone:217-722-7780
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-23
Last Update Date:2020-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL251J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care