Provider Demographics
NPI:1952463093
Name:MARRELLO, RORY JAMES (DC)
Entity Type:Individual
Prefix:DR
First Name:RORY
Middle Name:JAMES
Last Name:MARRELLO
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7003 W 114TH PL
Mailing Address - Street 2:
Mailing Address - City:WORTH
Mailing Address - State:IL
Mailing Address - Zip Code:60482-2042
Mailing Address - Country:US
Mailing Address - Phone:708-448-3624
Mailing Address - Fax:
Practice Address - Street 1:10250 CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:OAK LAWN
Practice Address - State:IL
Practice Address - Zip Code:60453-4602
Practice Address - Country:US
Practice Address - Phone:708-601-7679
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-14
Last Update Date:2009-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038-010497111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILV08390Medicare UPIN