Organization
MORRIS MAUER MD SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MORRIS MAUER MD (PRESIDENT)
(312) 813-8240
Entity
Organization
Contact information
Practice address
1600 W DEMPSTER ST, SUITE 120, PARK RIDGE, IL 60068-1109
(847) 299-7888
(708) 452-4593
Mailing address
2010 N HARLEM AVE, ELMWOOD PARK, IL 60707-3119
(708) 452-1111
(708) 452-4593
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
036070419
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036070419
—
IL
05
—
1215933825
—
IL
01
—
21620215
BLUE SHIELD OF ILLINOIS
IL
01
—
DP9686
MEDICARE RAILROAD
IL
Enumeration date
12/09/2009
Last updated
06/04/2010
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