Provider Demographics
NPI:1124545868
Name:DR. KATIE MAIER DC, LTD
Entity Type:Organization
Organization Name:DR. KATIE MAIER DC, LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KATIE
Authorized Official - Middle Name:
Authorized Official - Last Name:MAIER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:815-954-4351
Mailing Address - Street 1:662 N CONVENT ST
Mailing Address - Street 2:
Mailing Address - City:BOURBONNAIS
Mailing Address - State:IL
Mailing Address - Zip Code:60914-1332
Mailing Address - Country:US
Mailing Address - Phone:815-937-0446
Mailing Address - Fax:
Practice Address - Street 1:662 N CONVENT ST
Practice Address - Street 2:
Practice Address - City:BOURBONNAIS
Practice Address - State:IL
Practice Address - Zip Code:60914-1332
Practice Address - Country:US
Practice Address - Phone:815-937-0446
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-08-24
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center