Provider Demographics
NPI:1447583976
Name:M&M FAMILY MEDICINE ASSOCIATES
Entity Type:Organization
Organization Name:M&M FAMILY MEDICINE ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:KATE LYNN
Authorized Official - Middle Name:
Authorized Official - Last Name:MAXOURIS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:773-878-0825
Mailing Address - Street 1:5115 N FRANCISCO AVE
Mailing Address - Street 2:1ST FLOOR
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60625-3611
Mailing Address - Country:US
Mailing Address - Phone:773-878-0825
Mailing Address - Fax:773-878-0985
Practice Address - Street 1:5115 N FRANCISCO AVE
Practice Address - Street 2:1ST FLOOR
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60625-3611
Practice Address - Country:US
Practice Address - Phone:773-878-0825
Practice Address - Fax:773-878-0985
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-16
Last Update Date:2009-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty