Provider Demographics
NPI:1538467683
Name:MARELIC, KASEY REYNOLDS (MD)
Entity type:Individual
Prefix:DR
First Name:KASEY
Middle Name:REYNOLDS
Last Name:MARELIC
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:KASEY
Other - Middle Name:AILEEN
Other - Last Name:REYNOLDS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:333 S DESPLAINES ST STE 201
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60661-5514
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:8845 LYRA DR
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43240
Practice Address - Country:US
Practice Address - Phone:380-222-2731
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-03-14
Last Update Date:2024-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCMD500002958207VE0102X
FLME166195207VE0102X
GA97275207VE0102X
IL036.166990207VE0102X
IN01092222A207VE0102X
KYC1920207VE0102X
WV33258207VE0102X
OH35123721207VE0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VE0102XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyReproductive Endocrinology