MEDICARE: MARLU P JAVIER MD

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	208000000X	Pediatrics Physician	036052495	IL

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	:	1134186414
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARLU P JAVIER MD

Provider Business Mailing Address
First Line	:	237 WATERFORD DR
Second Line	:
City	:	WILLOW BROOK
State	:	IL
Zip	:	60527-5456
Country	:	US
Telephone Number	:	630-433-1849
Fax Number	:	773-873-1043

Provider Business Practice Location Address
First Line	:	6307 S STEWART AVE
Second Line	:	SUITE 311
City	:	CHICAGO
State	:	IL
Zip	:	60621-3116
Country	:	US
Telephone Number	:	773-962-4635
Fax Number	:	773-873-1043

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

Provider Enumeration Date	:	04/28/2006
Last Update Date	:	03/03/2017

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Directions to “ MARLU P JAVIER MD” Practice Location

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