Individual
DR. MARY MARYLAND
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP-C, PHD, MSN
Contact information
Practice address
1900 W TAYLOR ST, SUITE 172, CHICAGO, IL 60612-3742
(312) 413-2042
(312) 996-5984
Mailing address
420 HOME AVE, OAK PARK, IL 60302-3770
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
209003959
IL
Other
Enumeration date
07/11/2006
Last updated
07/08/2007
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