MEDICARE: MARY ANN LAUER

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	224Z00000X	Occupational Therapy Assistant	057003309	IL

General Provider Information

NPI Number	:	1962766543
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARY ANN LAUER

Provider Business Mailing Address
First Line	:	8311 CONCORD DR
Second Line	:
City	:	MORTON GROVE
State	:	IL
Zip	:	60053-2234
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	8311 CONCORD DR
Second Line	:
City	:	MORTON GROVE
State	:	IL
Zip	:	60053-2234
Country	:	US
Telephone Number	:	312-806-0377
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/28/2012
Last Update Date	:	06/28/2012

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Directions to “ MARY ANN LAUER ” Practice Location

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