| Doctor Name: | MS. VICKI ELIZABETH MARCUM |
| NPI Number: | 1154494193 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | LCSW |
| License Number: | 149008067 |
| Business Practice Address: | 11447 2nd St 9b Roscoe, IL - 610739522 |
| Business Phone Number: | 8159973225 |
| Business Fax Number: | 8159654732 |
| Mailing Address: | 6812 Claremont St, ROCKFORD |
| State: | IL |
| Postal Code: | 611021157 |
| Phone Number: | 8159973225 |
| Fax Number: | 8159654732 |
| NPI Enumeration Date: | 11/16/2006 |
| NPI Last Update Date: | 06/04/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1041C0700X |
| License Number: | 149008067 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | IL |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Social Worker |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | A social worker who holds a master |