Marlene K Henze MD PC

Primary specialty

Health Service Clinic/CenterTaxonomy code 261QH0100X

License

036093007 Issued in IL

Legal business name

MARLENE K HENZE MD PC

Practice address

151 W High St
Morris, IL 60450-1407

Phone

(815) 416-1331

Fax

(815) 634-3188

NPI assigned

Jul 26, 2010

Organization subpart

No

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

Authorized official

Name

Marlene K Henze, MD

Title

President

Phone

(815) 416-1331

Specialties & licenses 1

Addresses

Other identifiers 3

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

{
    "created_epoch": "1280102400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1316476800000",
    "number": "1437462975",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "35 E WILLOW ST STE B",
            "city": "COAL CITY",
            "state": "IL",
            "postal_code": "604161869",
            "telephone_number": "815-634-3048",
            "fax_number": "815-634-3188"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "151 W HIGH ST",
            "city": "MORRIS",
            "state": "IL",
            "postal_code": "604501407",
            "telephone_number": "815-416-1331",
            "fax_number": "815-634-3188"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARLENE K HENZE MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-07-26",
        "last_updated": "2011-09-20",
        "status": "A",
        "authorized_official_last_name": "HENZE",
        "authorized_official_first_name": "MARLENE",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "815-416-1331",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": "IL",
            "license": "036093007",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "080181425",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ILLINOIS MEDICAID",
            "identifier": "036093007",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF IL",
            "identifier": "3227787",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ashlie R Maher, OTR/L
• Christopher Jon Maier, ED.D., LPC
• Mahreen Majid, M.D.
• Angelo Marino, O. D.
• Mark a.Kijek MD SC
• Donald Martin
• Taylor Mathus
• Donald Maxon, LCPC
• Paul M Mazur, C.N.P.
• Anne McDonnell

• Health Service Clinic/Center in Morris, IL
• Providers in Morris, IL by specialty
• Health Service Clinic/Center in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.