Individual
MARYANN L MAHER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTRL
Contact information
Practice address
7804 COLLEGE DRIVE, SUITE 1 S.W., PALOS HEIGHTS, IL 60463
(708) 923-1332
(708) 923-1263
Mailing address
7804 COLLEGE DRIVE, SUITE 1 S.W., PALOS HEIGHTS, IL 60463
(708) 923-1332
(708) 923-1263
Taxonomy
Speciality
Code
Description
License number
State
2251P0200X
Pediatric Physical Therapist
Primary
056002299
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0001671508
BCBS PROVIDER NUMBER
IL
Enumeration date
02/27/2007
Last updated
02/04/2009
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