Most Relevant Information
Provider Data
| NPI Number: | 1003061896 |
| Provider Name: | MARILYN KAY SPALLA M.ED. |
| Entity Type: | Individual |
| Taxonomy Code: | 171W00000X |
| Specialty: | Contractor |
| License Number: | 2244762 ; 2359916 |
Most Important Dates
| Enumeration Date: | 11/20/2008 |
| Last Updated: | 11/20/2008 |
Provider Practice Location
5259 S NORDICA AVE
CHICAGO
IL
606381015
Practice Location Phone/Fax
| Phone: | 7733393876 |
| Fax: |
Provider Mailing Location
5259 S NORDICA AVE
CHICAGO
IL
606381015
Provider Mailing Phone/Fax
| Phone: | 7733393876 |
| Fax: |