Maicke, Theresa

Maicke, Theresa is an individual health care provider with primary practice located at 8420 W Bryn Mawr Ave Ste 300 , Chicago IL 60631-3436. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Interventional Pain Medicine, Allopathic & Osteopathic Physicians / Anesthesiology. Allopathic & Osteopathic Physicians / Anesthesiology is her primary health care specialty. Maicke, Theresa can be contacted via phone (708) 831-8282.

Contact Information

Primary practice address
8420 W Bryn Mawr Ave Ste 300 Chicago IL 60631-3436
Phone: (708) 831-8282
Fax: (773) 714-1229
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Interventional Pain Medicine 208VP0014X 036093939 Illinois
Allopathic & Osteopathic Physicians / Anesthesiology 207L00000X 036093939 Illinois

Profile Details

NPI number 1235197567
LBN Legal business name Maicke, Theresa
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 3rd, 2006
Last updated Jun 24th, 2021 - about 3 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1235197567 NPPES
Illinois MEDICAID 036093939

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