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General NPI Number Information
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NPI Number | 1740239359
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Entity Type | Organization
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Legal Business Name | MAR ASSOCIATES, LTD
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Dates
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Enumeration Date | 05/09/2006
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Last Update Date | 08/27/2009
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Provider Practice Location Address
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Address Line | 2222 W DIVISION ST SUITE 230
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City | CHICAGO
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State | IL
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Zip | 60622-2717
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Country | US
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Telephone | 773-342-0993
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Fax | 773-342-0996
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Provider Business Mailing Address
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Address Line | PO BOX 388320
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City | CHICAGO
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State | IL
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Zip | 60638-8320
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Country | US
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Telephone | 773-767-8283
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Fax | 773-767-8320
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Authorized Official
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Title or Position | PRESIDENT
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Name | MARCELO MUNOZ
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Credential | M.D.
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Telephone | 773-342-0993
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Y00000X
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Taxonomy Name | Otolaryngology Physician
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License Number | 036046253
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License Number State | IL
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