Dewberry-Lait, Mary Claire

Dewberry-Lait, Mary Claire is an individual health care provider with primary practice located at 1875 Dempster St Ste 180 , Park Ridge IL 60068-1144. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Family, Physician Assistants & Advanced Practice Nursing Providers / Adult Health. Physician Assistants & Advanced Practice Nursing Providers / Adult Health is her primary health care specialty. Dewberry-Lait, Mary Claire can be contacted via phone (844) 725-5238.

Contact Information

Primary practice address
1875 Dempster St Ste 180 Park Ridge IL 60068-1144
Phone: (844) 725-5238
Fax: (847) 723-2791
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 209003909 Illinois
Physician Assistants & Advanced Practice Nursing Providers / Adult Health 363LA2200X 209003909 Illinois

Profile Details

NPI number 1598811994
LBN Legal business name Dewberry-Lait, Mary Claire
Credentials Nurse Practitioner (NP)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 26th, 2007
Last updated Mar 10th, 2023 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1598811994 NPPES
Illinois MEDICAID 041235354
Illinois Other 406120108

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