Provider Demographics
NPI:1972578227
Name:MARQUARDT, STEVEN (MD)
Entity Type:Individual
Prefix:
First Name:STEVEN
Middle Name:
Last Name:MARQUARDT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1880 W WINCHESTER RD
Mailing Address - Street 2:101
Mailing Address - City:LIBERTYVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60048-5321
Mailing Address - Country:US
Mailing Address - Phone:847-281-9543
Mailing Address - Fax:847-281-9615
Practice Address - Street 1:1880 W WINCHESTER RD
Practice Address - Street 2:101
Practice Address - City:LIBERTYVILLE
Practice Address - State:IL
Practice Address - Zip Code:60048-5321
Practice Address - Country:US
Practice Address - Phone:847-281-9543
Practice Address - Fax:847-281-9615
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036070591207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036070591Medicaid
IL050079760OtherRAILROAD MEDICARE
IL0004930110OtherBCBS
IL111282OtherHEALTH PARTNERS