Mary I. Pitaro, M.D., LTD.

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

Legal business name

MARY I. PITARO, M.D., LTD.

Practice address

9050 W 81St St
Justice, IL 60458-1350

Phone

(708) 563-0088

Fax

(708) 563-0585

NPI assigned

Aug 6, 2007

Last updated

Aug 6, 2007By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Mary Iria Pitaro, M.D.NPI 1225196124

Title

President

Phone

(708) 563-0088

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Mary Iria Pitaro, M.D.

  • Internal Medicine Physician
  • Justice, IL
  • NPI 1225196124
  Authorized official Same address or phone

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1186358400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1186358400000",
    "number": "1184815987",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9050 W 81ST ST",
            "city": "JUSTICE",
            "state": "IL",
            "postal_code": "604581350",
            "telephone_number": "708-563-0088",
            "fax_number": "708-563-0585"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9050 W 81ST ST",
            "city": "JUSTICE",
            "state": "IL",
            "postal_code": "604581350",
            "telephone_number": "708-563-0088",
            "fax_number": "708-563-0585"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARY I. PITARO, M.D., LTD.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-06",
        "last_updated": "2007-08-06",
        "status": "A",
        "authorized_official_last_name": "PITARO",
        "authorized_official_first_name": "MARY",
        "authorized_official_middle_name": "IRIA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "708-563-0088",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF ILLINOIS",
            "identifier": "31604392",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Samrah Kelly
• Cheng H Lin
• Madhavi Gadde DMD LTD
• Subhan Manzoor, DDS
• Kali Marie Martin, MS SLP-CCC
• Katy Rose McCullough
• Shawon McDaniel
• Kathryn May McGee
• Yazmin Mendoza
• Metropolitan Family Services

• Primary Care Clinic/Center in Justice, IL
• Providers in Justice, IL by specialty
• Primary Care Clinic/Center in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.