Search › Illinois › 207Q00000X
Mara Divis, DO
NPI 1780824037 · on the registry since 2009 · sole proprietor
Practice
- Address
- 5501 W Fullerton Ave
Chicago, IL 60639 - Phone
- (733) 957-4007
- Fax
- (773) 395-9608
- Organisation at this address
- Cook County
Inferred from a shared address, not stated in the registry.
- Clinicians at this address
- 2
Registry record
- Primary taxonomy
- 207Q00000X
207Q00000X
- Also registered as
- 207Q00000X
207Q00000X - Licence states on file
- IN, OH, IL
From the registry's licence fields, which are often incomplete.
- Sex
- Female
- Record last updated
- 2025-04-11
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Illinois