Provider Demographics
NPI:1558384883
Name:MAREK, KATHERINE EMBRY (DNP, FNP-BC)
Entity Type:Individual
Prefix:DR
First Name:KATHERINE
Middle Name:EMBRY
Last Name:MAREK
Suffix:
Gender:F
Credentials:DNP, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2160 S 1ST AVE BLDG 54
Mailing Address - Street 2:
Mailing Address - City:MAYWOOD
Mailing Address - State:IL
Mailing Address - Zip Code:60153-3328
Mailing Address - Country:US
Mailing Address - Phone:708-216-3135
Mailing Address - Fax:708-216-8198
Practice Address - Street 1:2160 S 1ST AVE BLDG 54
Practice Address - Street 2:
Practice Address - City:MAYWOOD
Practice Address - State:IL
Practice Address - Zip Code:60153-3328
Practice Address - Country:US
Practice Address - Phone:708-216-3135
Practice Address - Fax:708-216-8198
Is Sole Proprietor?:No
Enumeration Date:2006-07-26
Last Update Date:2021-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209004004363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily