| Doctor Name: | DR. SCOTT WALTER MAIERITSCH |
| NPI Number: | 1013003698 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | PHD |
| License Number: | 071.006914 |
| Business Practice Address: | 5th & Roosevelt Rd Hines, IL - 601415000 |
| Business Phone Number: | 7082028387 |
| Business Fax Number: | |
| Mailing Address: | Po Box 5000, HINES |
| State: | IL |
| Postal Code: | 601415000 |
| Phone Number: | 7082028387 |
| Fax Number: | |
| NPI Enumeration Date: | 10/04/2006 |
| NPI Last Update Date: | 02/26/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TC0700X |
| License Number: | 071.006914 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | IL |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | |