Provider Demographics
NPI:1396929600
Name:RAMONA C MARSH MD SC
Entity type:Organization
Organization Name:RAMONA C MARSH MD SC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:RAMONA
Authorized Official - Middle Name:
Authorized Official - Last Name:MARSH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:630-852-9400
Mailing Address - Street 1:3825 HIGHLAND AVE
Mailing Address - Street 2:SUITE 4A
Mailing Address - City:DOWNERS GROVE
Mailing Address - State:IL
Mailing Address - Zip Code:60515-1552
Mailing Address - Country:US
Mailing Address - Phone:630-852-9400
Mailing Address - Fax:630-852-9766
Practice Address - Street 1:3825 HIGHLAND AVE
Practice Address - Street 2:SUITE 4A
Practice Address - City:DOWNERS GROVE
Practice Address - State:IL
Practice Address - Zip Code:60515-1552
Practice Address - Country:US
Practice Address - Phone:630-852-9400
Practice Address - Fax:630-852-9766
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-21
Last Update Date:2007-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL02223000OtherBLUE CROSS BLUE SHIELD
IL534460Medicare PIN
E40655Medicare UPIN