Individual
CYNTHIA LEE MAZURA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCPC
Contact information
Practice address
875 N DEARBORN ST, SUITE 204, CHICAGO, IL 60610-7377
(773) 334-0503
Mailing address
5925 N MAGNOLIA AVE, CHICAGO, IL 60660-3303
(773) 334-0503
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01608000
BLUE CROSS BLUE SHIELD
IL
Enumeration date
04/26/2007
Last updated
07/08/2007
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