Provider Demographics
NPI:1467855791
Name:ZELHART, MARIE (NP)
Entity Type:Individual
Prefix:
First Name:MARIE
Middle Name:
Last Name:ZELHART
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1000 REMINGTON BLVD
Mailing Address - Street 2:200
Mailing Address - City:BOLINGBROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60440-5114
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1000 REMINGTON BLVD
Practice Address - Street 2:200
Practice Address - City:BOLINGBROOK
Practice Address - State:IL
Practice Address - Zip Code:60440-5114
Practice Address - Country:US
Practice Address - Phone:630-312-7755
Practice Address - Fax:630-856-9933
Is Sole Proprietor?:No
Enumeration Date:2014-10-01
Last Update Date:2021-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209.011868363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner