Provider Demographics
NPI:1366823346
Name:MAURER, ABIGAIL (ATC)
Entity Type:Individual
Prefix:
First Name:ABIGAIL
Middle Name:
Last Name:MAURER
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2648 N 3739TH RD
Mailing Address - Street 2:
Mailing Address - City:SHERIDAN
Mailing Address - State:IL
Mailing Address - Zip Code:60551-9806
Mailing Address - Country:US
Mailing Address - Phone:815-712-3529
Mailing Address - Fax:
Practice Address - Street 1:701 COLLEGE RD
Practice Address - Street 2:
Practice Address - City:LEBANON
Practice Address - State:IL
Practice Address - Zip Code:62254-1291
Practice Address - Country:US
Practice Address - Phone:815-712-3529
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-15
Last Update Date:2015-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer