Provider Demographics
NPI:1487818100
Name:ALEMAN, MARIAH IRENE (OD)
Entity Type:Individual
Prefix:DR
First Name:MARIAH
Middle Name:IRENE
Last Name:ALEMAN
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:MARIAH
Other - Middle Name:I
Other - Last Name:HARVEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OD
Mailing Address - Street 1:5670 NORTHWEST HWY
Mailing Address - Street 2:
Mailing Address - City:CRYSTAL LAKE
Mailing Address - State:IL
Mailing Address - Zip Code:60014-8017
Mailing Address - Country:US
Mailing Address - Phone:815-382-5193
Mailing Address - Fax:
Practice Address - Street 1:5670 NORTHWEST HWY
Practice Address - Street 2:
Practice Address - City:CRYSTAL LAKE
Practice Address - State:IL
Practice Address - Zip Code:60014-8017
Practice Address - Country:US
Practice Address - Phone:815-382-5193
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-11
Last Update Date:2023-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL046.010063152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist