Individual
MARY E LYNN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
2160 S 1ST AVE, BLDG. 103, ROOM 1019, MAYWOOD, IL 60153-3328
(708) 216-3380
(708) 216-6148
Mailing address
2160 S 1ST AVE, BLDG. 103, ROOM 1019, MAYWOOD, IL 60153-3328
(708) 216-3380
(708) 216-6148
Taxonomy
Speciality
Code
Description
License number
State
207VG0400X
Gynecology Physician
Primary
036111813
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
43521100
—
WI
Enumeration date
11/03/2006
Last updated
05/07/2012
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