Provider Demographics
NPI:1346283736
Name:HALL, MARY CELESTE (MD)
Entity Type:Individual
Prefix:DR
First Name:MARY
Middle Name:CELESTE
Last Name:HALL
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Gender:F
Credentials:MD
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Mailing Address - Street 1:9631 GROSS POINT RD
Mailing Address - Street 2:SUITE 2
Mailing Address - City:SKOKIE
Mailing Address - State:IL
Mailing Address - Zip Code:60076-1264
Mailing Address - Country:US
Mailing Address - Phone:847-677-7250
Mailing Address - Fax:847-677-7251
Practice Address - Street 1:9631 GROSS POINT RD
Practice Address - Street 2:SUITE 2
Practice Address - City:SKOKIE
Practice Address - State:IL
Practice Address - Zip Code:60076-1264
Practice Address - Country:US
Practice Address - Phone:847-677-7250
Practice Address - Fax:847-677-7251
Is Sole Proprietor?:No
Enumeration Date:2006-06-14
Last Update Date:2010-07-30
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Provider Licenses
StateLicense IDTaxonomies
IL036-097808208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics