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MARIELLEN MARDIS MAT
NPI 1700450665
Specialist/Technologist - Athletic Trainer in Lake Bluff, IL

Active since May 16, 2021
30019 N WAUKEGAN RD APT 103, LAKE BLUFF, IL 60044(618) 980-0482 Get Directions Write a Review

NPPES record last updated: May 16, 2021. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Mariellen Mardis Mat NPPES

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

MARIELLEN MARDIS MAT (NPI 1700450665) is an individual athletic trainer provider in Lake Bluff, Illinois, licensed in Illinois (096.004744) and active in the NPI registry since May 2021.

NPPES Registry Identity

NPI1700450665
Entity TypeIndividualFemale
Primary Taxonomy2255A2300X
Provider Legal NameMARIELLEN MARDISCredential: MAT
Location Address30019 N WAUKEGAN RD APT 103Lake Bluff, IL 60044-1079
Mailing Address30019 N Waukegan Rd Apt 103Lake Bluff, IL 60044-1079 · (618) 980-0482
Phone(618) 980-0482
Sole ProprietorNo
Enumeration DateMay 16, 2021
NPPES CertifiedMay 16, 2021
✔ NPI 1700450665 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySpecialist/Technologist · Athletic TrainerRespiratory, Developmental, Rehabilitative and Restorative Service Providers
Taxonomy Code2255A2300X
License✔ Licensed in IL · 096.004744
Definition
Athletic trainers are allied health care professionals who work in consultation with or under the direction of physicians, and specialize in the prevention, assessment, treatment and rehabilitation of injuries and illnesses. Currently, the entry-level employment requirements are a bachelor's degree with a major in athletic training from an accredited university or college. A majority of athletic trainers hold advanced degrees. National board certification is generally required as a condition of state licensure and employment. Most states regulate athletic trainers, and they practice within the scope of that license or regulation. Clinical practice includes emergency care, rehabilitation, reconditioning, therapeutic exercise, wellness programs, exercise physiology, kinesiology, biomechanics, nutrition, psychology and health care administration.
30019 N WAUKEGAN RD APT 103, Lake Bluff, IL 60044
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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 Mariellen Mardis's NPI number?

The NPI number for Mariellen Mardis is 1700450665. It was assigned to this individual provider in the NPPES registry on May 16, 2021.

Where is Mariellen Mardis located?

Mariellen Mardis practices at 30019 N Waukegan Rd Apt 103, Lake Bluff, IL 60044. The listed phone number is (618) 980-0482.

What is Mariellen Mardis's specialty?

The primary specialty registered for this NPI is Specialist/Technologist, specializing in Athletic Trainer, with taxonomy code 2255A2300X.

When was this NPI record last updated?

The NPPES record for Mariellen Mardis was last updated on May 16, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.