Provider Demographics
NPI:1275545790
Name:KAUFMAN, MAURICE E SR
Entity Type:Individual
Prefix:DR
First Name:MAURICE
Middle Name:E
Last Name:KAUFMAN
Suffix:SR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:621 S 21ST AVE
Mailing Address - Street 2:
Mailing Address - City:MAYWOOD
Mailing Address - State:IL
Mailing Address - Zip Code:60153-1475
Mailing Address - Country:US
Mailing Address - Phone:708-712-0305
Mailing Address - Fax:708-343-4889
Practice Address - Street 1:1 WESTBROOK CORPORATE CTR
Practice Address - Street 2:SUITE 300
Practice Address - City:WESTCHESTER
Practice Address - State:IL
Practice Address - Zip Code:60154-5701
Practice Address - Country:US
Practice Address - Phone:708-712-0305
Practice Address - Fax:708-343-4889
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional