Tillema, Mary S

Tillema, Mary S is an individual health care provider with primary practice located at 2160 S First Ave (Maguire Center, Rm. 3307), Maywood IL 60153. She recently has only one registered license in Allopathic & Osteopathic Physicians / Neonatal-Perinatal Medicine, which is considered as her primary health care specialty. Tillema, Mary S can be contacted via phone (708) 216-4403.

Contact Information

Primary practice address
2160 S First Ave (Maguire Center, Rm. 3307) Maywood IL 60153
Phone: (708) 216-4403
Fax: (708) 216-3375
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Neonatal-Perinatal Medicine 2080N0001X 36092364 Illinois

Profile Details

NPI number 1346214319
LBN Legal business name Tillema, Mary S
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 15th, 2006
Last updated Mar 5th, 2010 - about 14 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 1346214319 NPPES
Illinois MEDICAID 36092364

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