Provider Demographics
NPI:1134709553
Name:FORST, MARINA PAPAIOANNOU (DPT, OCS, CERT MD)
Entity type:Individual
Prefix:
First Name:MARINA
Middle Name:PAPAIOANNOU
Last Name:FORST
Suffix:
Gender:F
Credentials:DPT, OCS, CERT MD
Other - Prefix:
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Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Mailing Address - Street 1:29373 NETWORK PL
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60673-5147
Mailing Address - Country:US
Mailing Address - Phone:847-390-5900
Mailing Address - Fax:
Practice Address - Street 1:3936 N MILWAUKEE AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60641-2703
Practice Address - Country:US
Practice Address - Phone:630-368-1771
Practice Address - Fax:708-658-2750
Is Sole Proprietor?:No
Enumeration Date:2021-04-09
Last Update Date:2023-03-01
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
225100000X
IL070013058225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist