Marissa Laurette Feeney, MD
Individual provider Active NPI Forensic Pathology Physician · Vandalia, IL
NPI 1669014189 · NPPES record last updated Oct 16, 2019
Key facts
- NPI
- 1669014189
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Forensic Pathology Physician 207ZF0201X
- License
- 036.141060 (IL)
- Practice address
- 692 E 1700 Ave
Vandalia, IL 62471-4028 - Phone
- (618) 704-5945
- Fax
- (888) 618-8106
- NPI assigned
- Oct 16, 2019
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036.141060 | IL | MD | Forensic Pathology Physician |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Forensic Pathology Physician | 207ZF0201X | 036.141060 | IL | Yes |
Addresses
Primary practice location
692 E 1700 Ave
Vandalia, IL 62471-4028
Mailing address
692 E 1700 Ave
Vandalia, IL 62471-4028
Phone (618) 704-5945
Other providers in Vandalia, IL
- Fayette County
- Fayette County
- Fayette County
- Fayette County Hospital
- Fayette County Hospital District
- Meri Brooke File-Miller
- Tina Fischer
- Callie Fleshren
- Heather Kay Foley
- Brent Frey
All providers in Vandalia, IL · Forensic Pathology Physician in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 16, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.