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General NPI Number Information
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NPI Number | 1861600447
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Entity Type | Organization
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Legal Business Name | M.A.Z. SERVICES, INC.
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Dates
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Enumeration Date | 05/18/2007
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Last Update Date | 02/28/2012
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Provider Practice Location Address
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Address Line | 5700 W FULLERTON AVE
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City | CHICAGO
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State | IL
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Zip | 60639-2307
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Country | US
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Telephone | 773-237-8660
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Fax | 773-237-3159
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Provider Business Mailing Address
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Address Line | 5700 W FULLERTON AVE
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City | CHICAGO
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State | IL
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Zip | 60639-2307
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Country | US
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Telephone | 773-237-8660
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Fax | 773-237-3159
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | CATHY CICERO
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Credential |
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Telephone | 773-237-8660
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP3300X
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Taxonomy Name | Pain Clinic/Center
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License Number |
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License Number State |
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