Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Mara Divis, DO

Individual provider Family Medicine Physician · NPI 1780824037

Mara Divis, DO is a Family Practice in Chicago, Illinois. Graduated from Kansas City University of Physicians and Surgeons in 2007, 19 years ago. Practices with Cook County, a 787-clinician group and accepts Medicare assignment. Licensed in Illinois, Indiana and Ohio.

Years since qualifying
19
Trained at
Kansas City University of Physicians and Surgeons
Licensed in
IL, IN, OH
In the registry since
2009
Specialties on file
3
What do these letters mean?
DO — Doctor of Osteopathic Medicine
A fully licensed physician, trained like an MD with additional musculoskeletal training. Equivalent practice rights in all 50 states.

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Practice location Address checks out

5501 W Fullerton Ave
Chicago, IL 60639-1368
Phone: (733) 957-4007
Fax: (773) 395-9608
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X · Licence 036129431 (IL)
Family Medicine Physician Taxonomy 207Q00000X · Licence 02003631A (IN)
Family Medicine Physician Taxonomy 207Q00000X · Licence 58.002346 (OH)

Record details

NPI number1780824037
Entity typeIndividual (Type 1)
GenderFemale
Credentials DO
Sole proprietorYes
NPI enumeratedFebruary 26, 2009
Last updated in NPPESApril 11, 2025
Certification dateApril 11, 2025

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyFAMILY PRACTICE
Medical schoolKANSAS CITY UNIVERSITY OF PHYSICIANS AND SURGEONS
Graduated 2007 (19 years in practice)
Group practice Cook County — 787 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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