Jennifer Marsidi, DO

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

125.077691 Issued in IL

Practice address

1645 W Jackson Blvd Ste 215
Chicago, IL 60612-3227

Phone

(312) 942-3254

NPI assigned

Nov 5, 2007

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Enrolled in ME

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Mercy Hospital

  • General Acute Care Hospital
  • Portland, ME
  • NPI 1629078712
  Medicare reassignment NPD
• Maine Medical Partners

  dba Maine Childrens Cancer Program

  • Pediatric Hematology & Oncology Physician
  • Scarborough, ME
  • NPI 1073527388
  Medicare reassignment
• Maine Medical Partners

  dba Maine Medical Partners Hospital Medicine

  • Hospitalist Physician
  • Portland, ME
  • NPI 1942315361

  Internal Medicine

  NPD
• Mercy Hospital

  dba Northern Light Mercy Health Center

  • Rural Health Clinic/Center
  • Windham, ME
  • NPI 1396496378
  NPD
• Waldo County General Hospital

  • General Acute Care Hospital
  • Belfast, ME
  • NPI 1295990935
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1194220800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621814400000",
    "number": "1275713588",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1645 W JACKSON BLVD STE 215",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606123227",
            "telephone_number": "312-942-3254"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1645 W JACKSON BLVD STE 215",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606123227",
            "telephone_number": "312-942-3254"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1321 Colby Ave",
            "address_purpose": "LOCATION",
            "city": "Everett",
            "state": "WA",
            "postal_code": "982011665",
            "country_code": "US",
            "telephone_number": "425-261-2000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MARSIDI",
        "first_name": "JENNIFER",
        "name_prefix": "Ms.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-11-05",
        "last_updated": "2021-05-24",
        "certification_date": "2021-05-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IL",
            "license": "125.077691",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WA",
            "license": "AP30007951",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "125.077691",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tamara Marshall, MD
• Renee Marshel, PHD
• Teuta Marsic, MD
• Brooke Marsico, PA-C
• Debra S. Marsico, PHD
• Marstech Healthcare Services, S.C.
• Samantha Marszalec, LSW
• Henryka Marszalek, DDS
• Magdalena Marszalek
• Richard Joseph Marszalek

• Internal Medicine Physician in Chicago, IL
• Providers in Chicago, IL by specialty
• Internal Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.