Provider Demographics
NPI:1841737848
Name:PENNY, MARIE FRANCES
Entity Type:Individual
Prefix:
First Name:MARIE
Middle Name:FRANCES
Last Name:PENNY
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 1:22332 GOVERNORS HWY UNIT 793
Mailing Address - Street 2:
Mailing Address - City:RICHTON PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60471-4437
Mailing Address - Country:US
Mailing Address - Phone:773-543-0341
Mailing Address - Fax:
Practice Address - Street 1:22332 GOVERNORS HWY UNIT 784
Practice Address - Street 2:
Practice Address - City:RICHTON PARK
Practice Address - State:IL
Practice Address - Zip Code:60471-4435
Practice Address - Country:US
Practice Address - Phone:773-543-0341
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-01-27
Last Update Date:2024-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172A00000XOther Service ProvidersDriver