Liszek, Mary Jo
Liszek, Mary Jo is an individual health care provider with primary practice located at 2160 S 1St Ave Fahey Bldg., Rm. 119), Maywood IL 60153. She recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as her primary health care specialty. Liszek, Mary Jo can be contacted via phone (708) 216-8563.Contact Information
Primary practice address
2160 S 1St Ave Fahey Bldg., Rm. 119)
Maywood IL 60153
Phone: (708) 216-8563
Fax: (708) 216-0346
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | 036079155 | Illinois |
Profile Details
| NPI number | 1194790204 |
|---|---|
| LBN Legal business name | Liszek, Mary Jo |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Feb 22nd, 2006 |
| Last updated | Aug 12th, 2009 - about 15 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1194790204 | NPPES |
| Illinois | MEDICAID | 036079155 |
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