Provider Demographics
NPI:1760260137
Name:OSTERHUES, MARLENA JOYCE
Entity Type:Individual
Prefix:
First Name:MARLENA
Middle Name:JOYCE
Last Name:OSTERHUES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:368 W BRENTWOOD DR
Mailing Address - Street 2:
Mailing Address - City:PALATINE
Mailing Address - State:IL
Mailing Address - Zip Code:60074-1014
Mailing Address - Country:US
Mailing Address - Phone:847-393-3764
Mailing Address - Fax:
Practice Address - Street 1:368 W BRENTWOOD DR
Practice Address - Street 2:
Practice Address - City:PALATINE
Practice Address - State:IL
Practice Address - Zip Code:60074-1014
Practice Address - Country:US
Practice Address - Phone:847-393-3764
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-18
Last Update Date:2023-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program