MEDICARE: MICHELE MAURO, PSY.D., P.C.

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	251S00000X	Community/Behavioral Health Agency	071.005532	IL

General Provider Information

NPI Number	:	1043487549
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MICHELE MAURO, PSY.D., P.C.

Provider Business Mailing Address
First Line	:	3309 COOL SPRINGS CT
Second Line	:
City	:	NAPERVILLE
State	:	IL
Zip	:	60564-8240
Country	:	US
Telephone Number	:	630-305-8876
Fax Number	:	630-305-8876

Provider Business Practice Location Address
First Line	:	3309 COOL SPRINGS CT
Second Line	:
City	:	NAPERVILLE
State	:	IL
Zip	:	60564-8240
Country	:	US
Telephone Number	:	630-305-8876
Fax Number	:	630-305-8876

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. MICHELE MAURO
Credential	:	PSY.D.
Telephone Number	:	630-305-8876

Provider Enumeration Date	:	05/13/2008
Last Update Date	:	05/13/2008

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