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ETHAN TYLER MARSHALL
NPI 1366292799
Student in an Organized Health Care Education/Training Program in Peoria, IL

Active since March 26, 2024
530 NE GLEN OAK AVE, PEORIA, IL 61637(507) 220-1519 Get Directions Write a Review

NPPES record last updated: March 26, 2024. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Ethan Tyler Marshall NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

ETHAN TYLER MARSHALL (NPI 1366292799) is an individual student in an organized health care education/training program in Peoria, Illinois and active in the NPI registry since March 2024.

NPPES Registry Identity

NPI1366292799
Entity TypeIndividualMale
Primary Taxonomy390200000X
Provider Legal NameETHAN TYLER MARSHALL
Location Address530 NE GLEN OAK AVEPeoria, IL 61637-0001
Mailing Address409 W Bishop StLuverne, MN 56156-1203 · (507) 220-1519
Phone(507) 220-1519
Sole ProprietorNo
Enumeration DateMarch 26, 2024
NPPES CertifiedMarch 26, 2024
✔ NPI 1366292799 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care
Taxonomy Code390200000X
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
530 NE GLEN OAK AVE, Peoria, IL 61637
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Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. DEEPAK S NAIR M.D.
Psychiatry & Neurology (Neurology)
530 NE GLEN OAK AVE
PEORIA, IL 61637
Peoria County (309) 655-2000
DR. HAMID MAHMOOD ZIA M.D
Pathology (Anatomic Pathology & Clinical Pathology)
530 NE GLEN OAK AVE, CENTRAL ILLINOIS PATHOLOGY SC
PEORIA, IL 61637
Peoria County (309) 624-9011
THOMAS JAMES MCMORROW MD
Pediatrics
530 NE GLEN OAK AVE
PEORIA, IL 61637
Peoria County (309) 655-2553
ERIC TYLER AMPARAN MD
Student in an Organized Health Care Education/Training Program
530 NE GLEN OAK AVE
PEORIA, IL 61637
Peoria County (309) 655-2274
ALEXANDRA ROPER MD
Surgery
530 NE GLEN OAK AVE
PEORIA, IL 61637
Peoria County (309) 655-2000
JAPMEHR KAUR SANDHU M.B.B.S.
Student in an Organized Health Care Education/Training Program
530 NE GLEN OAK AVE
PEORIA, IL 61637
Peoria County (309) 624-9351
THOMAS BLACKWELL JR. MD
Student in an Organized Health Care Education/Training Program
530 NE GLEN OAK AVE
PEORIA, IL 61637
Peoria County (309) 655-2000
LUKE KLOFT
Student in an Organized Health Care Education/Training Program
530 NE GLEN OAK AVE
PEORIA, IL 61637
Peoria County (309) 655-2109

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Ethan Marshall's NPI number?

The NPI number for Ethan Marshall is 1366292799. It was assigned to this individual provider in the NPPES registry on March 26, 2024.

Where is Ethan Marshall located?

Ethan Marshall practices at 530 NE Glen Oak Ave, Peoria, IL 61637. The listed phone number is (507) 220-1519.

What is Ethan Marshall's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

When was this NPI record last updated?

The NPPES record for Ethan Marshall was last updated on March 26, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.