| Organization Name: | MARY I. PITARO, M.D., LTD. |
| NPI Number: | 1184815987 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | MARY IRIA PITARO (PRESIDENT) |
| Mailing Address: | 9050 W 81st St Justice |
| State: | IL US |
| Postal Code: | 604581350 |
| Phone Number: | 7085630088 |
| Fax Number: | 7085630585 |
| NPI Enumeration Date: | 08/06/2007 |
| NPI Last Update Date: | 08/06/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QP2300X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | IL |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Primary Care |
| Taxonomy Definition: | |