Provider Demographics
NPI:1740552231
Name:TEODORI, MARSHA F (MSN, RN, CDE, CCRC)
Entity type:Individual
Prefix:
First Name:MARSHA
Middle Name:F
Last Name:TEODORI
Suffix:
Gender:F
Credentials:MSN, RN, CDE, CCRC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1725 W HARRISON ST STE 250
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60612-3861
Mailing Address - Country:US
Mailing Address - Phone:312-563-2094
Mailing Address - Fax:312-563-2096
Practice Address - Street 1:1725 W HARRISON ST STE 250
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60612-3861
Practice Address - Country:US
Practice Address - Phone:312-563-2094
Practice Address - Fax:312-563-2096
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-31
Last Update Date:2013-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL041288966163WD0400X
TX621586163WD0400X
CA933479163WD0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WD0400XNursing Service ProvidersRegistered NurseDiabetes Educator