Individual
MICHAEL MAITAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
304 W HAY ST STE 313, DECATUR, IL 62526-4170
(217) 876-2756
(217) 876-3585
Mailing address
304 W HAY ST STE 313, DECATUR, IL 62526-4170
(217) 876-2756
(217) 876-3585
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
036081217
IL
207RG0100X
Gastroenterology Physician
64928-20
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036081217
—
IL
05
—
100053840
—
WI
Enumeration date
02/12/2007
Last updated
11/21/2025
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