Individual
EDWARD J MAHER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT, AMPT, OCS, CMPT
Contact information
Practice address
625 E SAINT PAUL AVE, MILWAUKEE, WI 53202-5907
(414) 272-9595
(414) 272-9594
Mailing address
790 REMINGTON BLVD, BOLINGBROOK, IL 60440-4909
(630) 296-2223
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
4910-024
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1447294053
WI MEDICAID
WI
01
—
P01347424
RAILROAD MEDICARE
WI
Enumeration date
06/15/2006
Last updated
09/30/2014
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