Individual
MARIA MAE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
6 E PHILLIP RD, VERNON HILLS, IL 60061-1700
(847) 362-5353
(847) 362-5393
Mailing address
6 E PHILLIP RD, VERNON HILLS, IL 60061-1700
(847) 362-5353
(847) 362-5393
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
070.011093
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
40452400
—
WI
Enumeration date
10/26/2006
Last updated
05/15/2014
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