Individual
MARIA STAED DWYER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1775 DEMPSTER ST, PARK RIDGE, IL 60068-1143
(847) 723-7501
Mailing address
107 N EVANSTON AVE, ARLINGTON HEIGHTS, IL 60004-6617
Taxonomy
Speciality
Code
Description
License number
State
2251N0400X
Neurology Physical Therapist
Primary
070006676
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
07000-6676
PT LICENSE
IL
Enumeration date
09/10/2020
Last updated
12/11/2021
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