DR. MARY MARYLAND (NP-C, PHD, MSN) – Nurse Practitioner, NPI 1093740953

DR. MARY MARYLAND (NP-C, PHD, MSN) is a healthcare provider. based in Oak park, Illinois. specializing in Nurse Practitioner. They hold the professional credentials NP-C, PHD, MSN. They hold a License No. 209003959 (IL). The NPI Number for DR. MARY MARYLAND (NP-C, PHD, MSN) is 1093740953

Main info

Female
46 Years Of Experience
Accepts Medicare Assignment
Name
DR. MARY MARYLAND (NP-C, PHD, MSN)
NPI
1093740953
Phone
Not provided
Address
420 HOME AVE
Enumeration Date
11 July 2006
Last Update Date
8 July 2007

Doctor Profile

Medical School Name
OTHER
Secondary Phone
7732533933
Graduation Year
1980 (46 years ago)
PAC ID
5092787069
Group Practice PAC ID
7517109879
Professional Enrollment ID
I20040810000895
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience52
Completeness75
Years active:19State licenses:1Digital endpointsOther names

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Provider Addresses for DR. MARY MARYLAND (NP-C, PHD, MSN)

  • 420, South Home Avenue, Pleasant District, Oak Park, Cook County, Illinois, 60302, United States

    OAK PARK, IL 603023770

    Phone:

    Type: Mailing

  • 1900, West Taylor Street, Illinois Medical District, Near West Side, Chicago, West Chicago Township, Cook County, Illinois, 60612, United States

    SUITE 172

    CHICAGO, IL 606123742

    Phone: (312) 413-2042

    Fax: (312) 996-5984

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2004-08-10

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20040810000895INurse PractitionerILTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
99212Established patient office or other outpatient visit, 10-19 minutes4328$0
G0439Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit1111$0
View full utilization report →

Insurance plans in this area (ZIP 60302)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 7517109879View full group profile

Reviews

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Frequently asked questions

Where can patients find DR. MARY MARYLAND (NP-C, PHD, MSN)'s NPI?
You can confirm DR. MARY MARYLAND (NP-C, PHD, MSN) with NPI 1093740953; it appears in the national provider directory.
Is DR. MARY MARYLAND (NP-C, PHD, MSN) currently active in the NPI registry?
CMS-published data lists DR. MARY MARYLAND (NP-C, PHD, MSN) as an active registrant.
Does DR. MARY MARYLAND (NP-C, PHD, MSN) list a primary specialty?
If you are matching referrals, note Nurse Practitioner for DR. MARY MARYLAND (NP-C, PHD, MSN). Clinical services aligned with this taxonomy classification.
What location shows for DR. MARY MARYLAND (NP-C, PHD, MSN)?
We surface Oak Park, Illinois for DR. MARY MARYLAND (NP-C, PHD, MSN) based on available NPPES addresses.
How can I contact DR. MARY MARYLAND (NP-C, PHD, MSN)?
Phone or fax may appear on the official NPI record when supplied — verify before relying on them.

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