Provider Demographics
NPI:1427555945
Name:OLIVER, MAURICE ALLEN JR (DPT)
Entity type:Individual
Prefix:DR
First Name:MAURICE
Middle Name:ALLEN
Last Name:OLIVER
Suffix:JR
Gender:
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:2001 BUTTERFIELD RD STE 1600
Mailing Address - Street 2:
Mailing Address - City:DOWNERS GROVE
Mailing Address - State:IL
Mailing Address - Zip Code:60515-1211
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:15630 OLD COLUMBIA PIKE STE F
Practice Address - Street 2:
Practice Address - City:BURTONSVILLE
Practice Address - State:MD
Practice Address - Zip Code:20866-1617
Practice Address - Country:US
Practice Address - Phone:240-559-5270
Practice Address - Fax:240-559-5271
Is Sole Proprietor?:No
Enumeration Date:2018-04-11
Last Update Date:2025-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEJ1-0014363225100000X
NCP18425225100000X
SCPT.9629225100000X
VACP017357T225100000X
MD225100000X
MI5501302647225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist