Individual
MS. MARY CLAIRE DEWBERRY-LAIT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1875 DEMPSTER ST STE 180, PARK RIDGE, IL 60068-1144
(844) 725-5238
(847) 723-2791
Mailing address
29373 NETWORK PL, CHICAGO, IL 60673-3500
(847) 390-5900
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
209003909
IL
363LF0000X
Family Nurse Practitioner
209003909
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
041235354
—
IL
01
—
406120108
PTAN
—
Enumeration date
01/26/2007
Last updated
03/10/2023
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