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General NPI Number Information
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NPI Number | 1427052273
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Entity Type | Individual
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Provider Name | JUSTIN T MAO MD
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Gender | Male
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Dates
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Enumeration Date | 06/09/2005
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Last Update Date | 04/21/2025
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Provider Practice Location Address
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Address Line | 3825 HIGHLAND AVE FL TOWER24
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City | DOWNERS GROVE
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State | IL
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Zip | 60515-1552
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Country | US
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Telephone | 630-719-4799
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Fax | 630-963-7420
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Provider Business Mailing Address
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Address Line | 29373 NETWORK PL
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City | CHICAGO
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State | IL
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Zip | 60673-1293
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Country | US
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Telephone | 847-390-5900
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 219331
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License Number State | MA
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 036-124995
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License Number State | IL
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Taxonomy #3
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | 036-124995
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License Number State | IL
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Taxonomy #4
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | 225456
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License Number State | MI
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Taxonomy #5
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Taxonomy Code | 207RC0001X
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Taxonomy Name | Clinical Cardiac Electrophysiology Physician
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License Number | 036-124995
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License Number State | IL
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