Provider Demographics
NPI:1285891713
Name:MARLU P. JAVIER, MD SC
Entity type:Organization
Organization Name:MARLU P. JAVIER, MD SC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROPRIETOR
Authorized Official - Prefix:
Authorized Official - First Name:MARLU
Authorized Official - Middle Name:P
Authorized Official - Last Name:JAVIER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:773-723-7602
Mailing Address - Street 1:237 WATERFORD DR
Mailing Address - Street 2:
Mailing Address - City:WILLOWBROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60527-5456
Mailing Address - Country:US
Mailing Address - Phone:773-723-7602
Mailing Address - Fax:773-723-9298
Practice Address - Street 1:6853 S HALSTED ST
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60621-1868
Practice Address - Country:US
Practice Address - Phone:773-723-7602
Practice Address - Fax:773-723-9298
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-21
Last Update Date:2008-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty