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1912943937
MARISA VANDER MEEDEN
CHICAGO, IL
NPI
1912943937
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Former Name
MARISA KRENKEL
Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363A00000X Physician Assistant
(Licence: IL 085001870)
Enumeration Date
2006-06-20
Last Update Date
2010-08-09
Business Address
-- MARISA VANDER MEEDEN PA
675 N SAINT CLAIR ST
CHICAGO, IL 60611-5975
Phone number: 312-695-9797
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Mailing Address
-- MARISA VANDER MEEDEN PA
675 N SAINT CLAIR ST
CHICAGO, IL 60611-5975
Phone number: 312-695-9797
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