Provider Demographics
NPI:1972663672
Name:MARCHESE, KATHERINE E (APN)
Entity Type:Individual
Prefix:
First Name:KATHERINE
Middle Name:E
Last Name:MARCHESE
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2180 PFINGSTEN RD STE 3000
Mailing Address - Street 2:
Mailing Address - City:GLENVIEW
Mailing Address - State:IL
Mailing Address - Zip Code:60026-1340
Mailing Address - Country:US
Mailing Address - Phone:847-503-3000
Mailing Address - Fax:847-503-3500
Practice Address - Street 1:2180 PFINGSTEN RD STE 3000
Practice Address - Street 2:
Practice Address - City:GLENVIEW
Practice Address - State:IL
Practice Address - Zip Code:60026-1340
Practice Address - Country:US
Practice Address - Phone:847-503-3000
Practice Address - Fax:847-503-3500
Is Sole Proprietor?:No
Enumeration Date:2006-12-11
Last Update Date:2021-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209.007486363LF0000X
IL041-156312163W00000X
IL209002628363LF0000X
IL209-002628364S00000X
IL209007486363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse
No364S00000XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse Specialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILIL4056006Medicare PIN
IL$$$$$$$$$001Medicaid
IL569810004Medicare PIN