Provider Demographics
NPI:1316116791
Name:GETZ, MARJORIE A (PHD)
Entity type:Individual
Prefix:
First Name:MARJORIE
Middle Name:A
Last Name:GETZ
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:MARJORIE
Other - Middle Name:A
Other - Last Name:SHEFTEL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PHD
Mailing Address - Street 1:1675 DEMPSTER ST
Mailing Address - Street 2:
Mailing Address - City:PARK RIDGE
Mailing Address - State:IL
Mailing Address - Zip Code:60068-1110
Mailing Address - Country:US
Mailing Address - Phone:847-318-9067
Mailing Address - Fax:
Practice Address - Street 1:1675 DEMPSTER ST
Practice Address - Street 2:
Practice Address - City:PARK RIDGE
Practice Address - State:IL
Practice Address - Zip Code:60068-1110
Practice Address - Country:US
Practice Address - Phone:847-318-9067
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-02-29
Last Update Date:2008-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL2047226171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator