Provider Demographics
NPI:1801273115
Name:TRESPECES, MARLON (LMT)
Entity type:Individual
Prefix:MR
First Name:MARLON
Middle Name:
Last Name:TRESPECES
Suffix:
Gender:M
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4635 N MALDEN ST # 1N
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60640-6394
Mailing Address - Country:US
Mailing Address - Phone:312-961-7486
Mailing Address - Fax:
Practice Address - Street 1:999 N PLAZA DR
Practice Address - Street 2:SUITE 115
Practice Address - City:SCHAUMBURG
Practice Address - State:IL
Practice Address - Zip Code:60173-6022
Practice Address - Country:US
Practice Address - Phone:847-706-9600
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-05-06
Last Update Date:2015-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL227.013370225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist