Active NPI
Marlise Frey, CNP
- Nurse Practitioner
- Chicago, IL
National Provider Identifier
1104835495
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- 209-000399
- Practice address
- 1725 W Harrison St
#1118
Chicago, IL 60612-3841 - Phone
- (312) 942-5936
- Fax
- (312) 942-2380
- NPI assigned
- Aug 5, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 209-000399 | IL | Primary |
Addresses
Primary practice location
1725 W Harrison St
#1118
Chicago, IL 60612-3841
Mailing address
1653 W Congress Pkwy
#348 Murdock
Chicago, IL 60612-3833
Phone (312) 942-5939
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 309-000238 | Other | IL | CONTROLLED SUBSTANCE LICE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Certified Nurse Practitioner, Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 209-000399 | IL | MD | Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1154736000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1678147200000",
"number": "1104835495",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1653 W CONGRESS PKWY",
"address_2": "#348 MURDOCK",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606123833",
"telephone_number": "312-942-5939",
"fax_number": "312-942-2238"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1725 W HARRISON ST",
"address_2": "#1118",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606123841",
"telephone_number": "312-942-5936",
"fax_number": "312-942-2380"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FREY",
"first_name": "MARLISE",
"name_prefix": "Mrs.",
"credential": "CNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-08-05",
"last_updated": "2023-03-07",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "IL",
"license": "209-000399",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CONTROLLED SUBSTANCE LICE",
"identifier": "309-000238",
"state": "IL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Chicago, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.