Theodore Mazzone

NPI 1962515403 - Internal Medicine - 207RE0101X

NPI Details
NPI 1962515403
Gender Male
Enumeration Date 08/17/2006
Last Updated 06/23/2008
Entity Type Individual
Active Over 11 years ago
Practice Location
CHICAGO IL, 60612-7232, US
Phone (866) 600-2273
Business Location
1819 W POLK ST
612 CMW, MC 797
CHICAGO IL, 60612-4356, US
Phone (312) 996-7989
Fax (312) 413-0437
Taxonomy Code 207RE0101X
License State Illinois
License Number 036066566
Remove 1962515403 NPI Number

According to our database, Theodore Mazzone NPI is 1962515403, taxonomy code is 207RE0101X and license number is 036066566, license state is located at Illinois. Theodore Mazzone physically located at 1740 W Taylor St, Chicago IL, 60612-7232. NPI Number Theodore Mazzone has the Individual type.

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1962515403 NPI number is provided on an as is basis without warranty of any kind. 1962515403 is maintained by the National Plan & Provider Enumeration System. The contents of Theodore Mazzone are for informational purposes only.