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Physician Compare National (NPI:1346572666)

HEALTHCARE PROVIDER: MAREN W DEAVER LCSW

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information

NPI 1346572666
Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID 9133306087
Unique individual clinician ID assigned by PECOS
Professional Enrollment ID I20110602000297
Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name DEAVER
Individual professional last name
Provider First Name MAREN
Individual professional first name
Provider Middle Name W
Individual professional middle name
Provider Gender F
The provider's gender if the provider is a person.

Medical School Information

Medical School Name OTHER
Individual professional's medical school
Graduation Year 2005
Individual professional's medical school graduation year
Primary Specialty CLINICAL SOCIAL WORKER
Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information

Line 1 Street Address 2530 CRAWFORD AVE
Group Practice or individual's line 1 address
Line 2 Street Address SUITE 219
Group Practice or individual's line 2 address
City EVANSTON
Group Practice or individual's city
State IL
Group Practice or individual's state
Zip Code 602014959
Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information

Professional Accepts Medicare Assignment Y

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