Provider Demographics
NPI:1972512705
Name:SEFTON, MARLENE GAIL SMITH (APN, FNP-BC)
Entity Type:Individual
Prefix:DR
First Name:MARLENE
Middle Name:GAIL SMITH
Last Name:SEFTON
Suffix:
Gender:F
Credentials:APN, FNP-BC
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:845 S. DAMEN AVE.
Mailing Address - Street 2:PMA DEPT. SUITE 1008 UIC COLLEGE OF NURSING (MC802)
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60612-7350
Mailing Address - Country:US
Mailing Address - Phone:312-996-7972
Mailing Address - Fax:312-996-9049
Practice Address - Street 1:845 S. DAMEN AVE.
Practice Address - Street 2:PMA DEPT. SUITE 1008 UIC COLLEGE OF NURSING (MC802)
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60612-7350
Practice Address - Country:US
Practice Address - Phone:312-996-7972
Practice Address - Fax:312-996-9049
Is Sole Proprietor?:No
Enumeration Date:2006-08-08
Last Update Date:2009-08-28
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IL209001438363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL0040030714OtherBC/BS
ILS89490Medicare UPIN
IL544480Medicare ID - Type Unspecified