Provider Demographics
NPI:1982038436
Name:THUERMER, MARY C (L AC)
Entity Type:Individual
Prefix:
First Name:MARY
Middle Name:C
Last Name:THUERMER
Suffix:
Gender:F
Credentials:L AC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:2542 W SUMMERDALE AVE
Mailing Address - Street 2:2FF
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60625-2340
Mailing Address - Country:US
Mailing Address - Phone:773-259-4232
Mailing Address - Fax:
Practice Address - Street 1:1318 CHICAGO AVE
Practice Address - Street 2:
Practice Address - City:EVANSTON
Practice Address - State:IL
Practice Address - Zip Code:60201-4725
Practice Address - Country:US
Practice Address - Phone:847-475-4960
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-02
Last Update Date:2013-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL198.001108171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist