MARISSA JANE VERSALLE

LAKE FOREST, IL
NPI1669891107
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy208M00000X Hospitalist
(Licence: IL  036.146901)
Additional Taxonomies208M00000X Hospitalist
(Licence: OH  34.012714)
390200000X Student in an Organized Health Care Education/Training Program
Enumeration Date2014-04-14
Last Update Date2018-07-24
Business Address
MARISSA JANE VERSALLE DO
1000 N WESTMORELAND RD
LAKE FOREST, IL 60045
Phone number: 847-234-5600
Mailing Address
MARISSA JANE VERSALLE DO
1000 N WESTMORELAND RD
LAKE FOREST, IL 60045-1658
Phone number: 847-234-5600