MARA DIVIS

CHICAGO, IL
NPI1780824037
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy207Q00000X Family Medicine
(Licence: IL  036129431)
Additional Taxonomies207Q00000X Family Medicine
(Licence: IN  02003631a)
207Q00000X Family Medicine
(Licence: OH  58.002346)
Enumeration Date2009-02-26
Last Update Date2025-04-11
Business Address
MARA DIVIS DO
5501 W FULLERTON AVE
CHICAGO, IL 60639-1368
Phone number: 733-957-4007
Mailing Address
MARA DIVIS DO
5501 W FULLERTON AVE
CHICAGO, IL 60639-1368
Phone number: 773-395-7400