Provider Demographics
NPI:1811218381
Name:MAHIEU, MARY A (MD)
Entity Type:Individual
Prefix:DR
First Name:MARY
Middle Name:A
Last Name:MAHIEU
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:240 E HURON ST
Mailing Address - Street 2:MCGAW M-300
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60611-2909
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:675 N SAINT CLAIR ST
Practice Address - Street 2:GALTER 14-100
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60611-5975
Practice Address - Country:US
Practice Address - Phone:312-695-8628
Practice Address - Fax:312-695-0110
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-18
Last Update Date:2016-08-30
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
IL036131440207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology