Provider Demographics
NPI:1821580580
Name:MARQUARDT, MARGARET WELDON (MED/EDS, NCSP)
Entity Type:Individual
Prefix:
First Name:MARGARET
Middle Name:WELDON
Last Name:MARQUARDT
Suffix:
Gender:F
Credentials:MED/EDS, NCSP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:850 HIGHLAND GROVE DR
Mailing Address - Street 2:
Mailing Address - City:BUFFALO GROVE
Mailing Address - State:IL
Mailing Address - Zip Code:60089-1549
Mailing Address - Country:US
Mailing Address - Phone:847-955-3600
Mailing Address - Fax:
Practice Address - Street 1:850 HIGHLAND GROVE DR
Practice Address - Street 2:
Practice Address - City:BUFFALO GROVE
Practice Address - State:IL
Practice Address - Zip Code:60089-1549
Practice Address - Country:US
Practice Address - Phone:847-955-3600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-05-30
Last Update Date:2018-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL2320661103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool