Provider Demographics
NPI:1225478506
Name:MAURER, KATIE C (OD)
Entity Type:Individual
Prefix:DR
First Name:KATIE
Middle Name:C
Last Name:MAURER
Suffix:
Gender:F
Credentials:OD
Other - Prefix:DR
Other - First Name:KATIE
Other - Middle Name:M
Other - Last Name:CUPURO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OD
Mailing Address - Street 1:456 W NORTHWEST HWY
Mailing Address - Street 2:SUITE 100
Mailing Address - City:PALATINE
Mailing Address - State:IL
Mailing Address - Zip Code:60067-2560
Mailing Address - Country:US
Mailing Address - Phone:847-358-4951
Mailing Address - Fax:847-358-4990
Practice Address - Street 1:456 W NORTHWEST HWY
Practice Address - Street 2:SUITE 100
Practice Address - City:PALATINE
Practice Address - State:IL
Practice Address - Zip Code:60067-2560
Practice Address - Country:US
Practice Address - Phone:847-358-4951
Practice Address - Fax:847-358-4990
Is Sole Proprietor?:No
Enumeration Date:2013-07-01
Last Update Date:2017-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL046.010693152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist