Provider Type Icon

MARISSA JANE VERSALLE DO NPI 1669891107


NPI Information

NPI: 1669891107
Provider Name: MARISSA JANE VERSALLE, DO
Classification: Hospitalist - 208M00000X
Entity Type: Individual

PECOS Registration: Yes

Address:
1000 N WESTMORELAND RD
LAKE FOREST, IL
ZIP 60045
Phone: (847) 234-5600
Get Directions

Marissa Jane Versalle, DO is a hospitalist in Lake Forest, IL with 10 years of experience. The provider is hospitalists are physicians whose primary professional focus is the general medical care of hospitalized patients. Their activities include patient care, teaching, research, and leadership related to Hospital Medicine. The term 'hospitalist' refers to physicians whose practice emphasizes providing care for hospitalized patients. Marissa Jane Versalle, DO NPI is 1669891107. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

Education
Medical School: LAKE ERIE COLLEGE OF OSTEOPATHIC MEDICINE, ERIE
Graduation Year:2014

The provider's business location address is:

1000 N WESTMORELAND RD
LAKE FOREST, IL
ZIP 60045
Phone: (847) 234-5600
Fax: (847) 535-7203

The NPI 1669891107 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 4/14/2014 and was last updated on 7/24/2018.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1208M00000XHospitalist34.012714OHIONo
2390200000XStudent in an Organized Health Care Education/Training ProgramNo
3208M00000XHospitalist036.146901ILLINOISYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.