MEDICARE: MRS. MARYANNETTE E NORA M.D.

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	207R00000X	Internal Medicine Physician	036081784	IL

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	110040056	OTHER	IL	MEDICARE RAILROAD
3	CF5018	OTHER	IL	MEDICARE RAILROAD

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1053339499
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. MARYANNETTE E NORA M.D.

Provider Business Mailing Address
First Line	:	6969 N LINCOLN AVE
Second Line	:
City	:	LINCOLNWOOD
State	:	IL
Zip	:	60712-2527
Country	:	US
Telephone Number	:	847-674-1200
Fax Number	:	847-674-1332

Provider Business Practice Location Address
First Line	:	6969 N LINCOLN AVE
Second Line	:
City	:	LINCOLNWOOD
State	:	IL
Zip	:	60712-2527
Country	:	US
Telephone Number	:	847-674-1200
Fax Number	:	847-674-1332

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/17/2006
Last Update Date	:	06/13/2011

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