Provider Demographics
NPI:1457650285
Name:CATALANO, MARIAN (FNP-BC)
Entity Type:Individual
Prefix:MRS
First Name:MARIAN
Middle Name:
Last Name:CATALANO
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:MRS
Other - First Name:MARIAN
Other - Middle Name:
Other - Last Name:YELLO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FNP-BC
Mailing Address - Street 1:1675 DEMPSTER ST # Y3-254
Mailing Address - Street 2:
Mailing Address - City:PARK RIDGE
Mailing Address - State:IL
Mailing Address - Zip Code:60068-1110
Mailing Address - Country:US
Mailing Address - Phone:847-723-7700
Mailing Address - Fax:847-723-9418
Practice Address - Street 1:1675 DEMPSTER ST # Y3-254
Practice Address - Street 2:
Practice Address - City:PARK RIDGE
Practice Address - State:IL
Practice Address - Zip Code:60068-1110
Practice Address - Country:US
Practice Address - Phone:847-723-7700
Practice Address - Fax:847-723-9418
Is Sole Proprietor?:No
Enumeration Date:2011-03-18
Last Update Date:2016-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209008000363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL206008000OtherSTATE OF ILLINOIS