ALYCE MARSHALL

On Hold
Details
Basic Information
Patient Record Number: MA428232
Date of Birth: 11/21/1932
Age: 93
Sex: N/A
SSN: N/A
Medicare Number: N/A
Contact Information
Mobile Phone: (773) 308-5558
Home Phone: (773) 721-6578
Email: N/A
Emergency Contact: N/A
Emergency Phone: N/A
Last Seen: 03/01/2022
Address Information
8941 S CLYDE AVE
Chicago, IL 60617
Coordinates: 41.73224340000001, -87.5728558
Home Health Nurse
CROWN HOME HEALTH AGENCY
Phone: 773-481-1778
Fax: 773-481-1353
Status: Inactive
Medicare Part B Deductible

No deductible information available

Annual Wellness Visit

No wellness visit information available

Appointments
Certifications
05/16/2022 - 07/14/2022
Expired
SOC: 03/17/2022
Discharge History
View All

No discharge history

Patient Actions
Appointment History
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485 Certifications
Start Date End Date Status Type Notes Actions
05/16/2022 07/14/2022 Expired N/A SOC: 03/17/2022
Patient On Hold
Hold Reason: no poc 2025
Hold Since: 07/03/2025
Hold Until: Indefinite