MEDICARE: M.A.Z. SERVICES, INC.

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	261QP3300X	Pain Clinic/Center

General Provider Information

NPI Number	:	1861600447
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	M.A.Z. SERVICES, INC.

Provider Business Mailing Address
First Line	:	5700 W FULLERTON AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60639-2307
Country	:	US
Telephone Number	:	773-237-8660
Fax Number	:	773-237-3159

Provider Business Practice Location Address
First Line	:	5700 W FULLERTON AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60639-2307
Country	:	US
Telephone Number	:	773-237-8660
Fax Number	:	773-237-3159

Authorized Official
Title or Position	:	OFFICE MANAGER
Name	:	CATHY CICERO
Credential	:
Telephone Number	:	773-237-8660

Provider Enumeration Date	:	05/18/2007
Last Update Date	:	02/28/2012

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