Provider Demographics
NPI:1851438162
Name:MAJER, MARY ANN (LICENSED CLINICAL SO)
Entity Type:Individual
Prefix:MS
First Name:MARY ANN
Middle Name:
Last Name:MAJER
Suffix:
Gender:F
Credentials:LICENSED CLINICAL SO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4441 NORTH MALDEN ST
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60640
Mailing Address - Country:US
Mailing Address - Phone:773-769-4074
Mailing Address - Fax:773-769-4074
Practice Address - Street 1:4441 NORTH MALDEN ST
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60640
Practice Address - Country:US
Practice Address - Phone:773-769-4074
Practice Address - Fax:773-769-4074
Is Sole Proprietor?:No
Enumeration Date:2007-01-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL12519800OtherDEPT OF HUMAN RIGHTS
212846Medicare ID - Type Unspecified