Mary Iria Pitaro, M.D.
Individual provider Active NPI Internal Medicine Physician · Justice, IL
NPI 1225196124 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1225196124
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Internal Medicine Physician 207R00000X
- Practice address
- 9050 W 81St St
Justice, IL 60458-1350 - Phone
- (708) 563-0088
- Fax
- (708) 563-0585
- NPI assigned
- Dec 4, 2006
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036-068669 | IL | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Medicall Physicians Group, LTD. | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | IL | Yes |
Addresses
Primary practice location
9050 W 81St St
Justice, IL 60458-1350
Mailing address
9050 W 81St St
Justice, IL 60458-1350
Phone (708) 563-0088
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0031604392 | Other | IL | BCBS |
Other providers in Justice, IL
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- Palos Pathology Associates LTD
- Pam Eernisse DPM SC
- Quantum Prosthetics & Orthotics LLC
- Ronisha Rhoden
- Robert T Miserendino DDS LTD
- Roberts Park Fire Protection District
- Ruth L Rosol
All providers in Justice, IL · Internal Medicine Physician in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.