Provider Demographics
NPI:1891705463
Name:MAUER, ANN MARIE (MD)
Entity type:Individual
Prefix:DR
First Name:ANN
Middle Name:MARIE
Last Name:MAUER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:CRETICOS CANCER CENTER
Mailing Address - Street 2:900 WEST NELSON ST
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60657
Mailing Address - Country:US
Mailing Address - Phone:773-296-7089
Mailing Address - Fax:773-296-7731
Practice Address - Street 1:CENTER FOR ADVANCED CARE
Practice Address - Street 2:900 WEST NELSON ST
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60657
Practice Address - Country:US
Practice Address - Phone:773-296-7089
Practice Address - Fax:773-296-7311
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-08
Last Update Date:2021-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036-090420174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILG87767Medicare UPIN