Healthcare Provider Details

I. General information

NPI: 1013907393
Provider Name (Legal Business Name): WILLIAM A FITZMAURICE JR. M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/26/2005
Last Update Date: 10/18/2022
Certification Date: 10/18/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

360 W BUTTERFIELD RD SUITE 250
ELMHURST IL
60126-5068
US

IV. Provider business mailing address

360 W BUTTERFIELD RD SUITE 250
ELMHURST IL
60126-5068
US

V. Phone/Fax

Practice location:
  • Phone: 630-832-4210
  • Fax: 630-832-8110
Mailing address:
  • Phone: 630-832-4210
  • Fax: 630-832-8110

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number036-075014
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: