Provider Demographics
NPI:1801533641
Name:MAURER, ISABELLE LEE
Entity type:Individual
Prefix:
First Name:ISABELLE
Middle Name:LEE
Last Name:MAURER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16232 E CLARKSVILLE RD
Mailing Address - Street 2:
Mailing Address - City:MARSHALL
Mailing Address - State:IL
Mailing Address - Zip Code:62441-3805
Mailing Address - Country:US
Mailing Address - Phone:217-293-0154
Mailing Address - Fax:
Practice Address - Street 1:812 N 8TH ST
Practice Address - Street 2:
Practice Address - City:MARSHALL
Practice Address - State:IL
Practice Address - Zip Code:62441-1313
Practice Address - Country:US
Practice Address - Phone:217-504-4099
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-13
Last Update Date:2022-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide