Provider Demographics
NPI:1205921830
Name:FLEURY, MARIE R (DO)
Entity type:Individual
Prefix:
First Name:MARIE
Middle Name:R
Last Name:FLEURY
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:MARIE
Other - Middle Name:R
Other - Last Name:DIFILIPPO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DO
Mailing Address - Street 1:4551 HATCH LANE
Mailing Address - Street 2:
Mailing Address - City:LISLE
Mailing Address - State:IL
Mailing Address - Zip Code:60532
Mailing Address - Country:US
Mailing Address - Phone:630-964-2504
Mailing Address - Fax:
Practice Address - Street 1:77 N. AIRLITE ST.
Practice Address - Street 2:
Practice Address - City:ELGIN
Practice Address - State:IL
Practice Address - Zip Code:60120
Practice Address - Country:US
Practice Address - Phone:847-695-3200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-03
Last Update Date:2007-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036-090960207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILG15435Medicare UPIN
ILK38424Medicare PIN