Provider Demographics
NPI:1578643680
Name:SEGAL, MARSHALL B (M,D)
Entity Type:Individual
Prefix:DR
First Name:MARSHALL
Middle Name:B
Last Name:SEGAL
Suffix:
Gender:M
Credentials:M,D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2142 N SEDGWICK ST
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60614-4620
Mailing Address - Country:US
Mailing Address - Phone:773-327-0777
Mailing Address - Fax:773-248-4825
Practice Address - Street 1:2000 OGDEN AVE
Practice Address - Street 2:RUSH COPLEY MEDICAL CENTER ED
Practice Address - City:AURORA
Practice Address - State:IL
Practice Address - Zip Code:60504-7222
Practice Address - Country:US
Practice Address - Phone:630-978-4810
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine