Individual
DR. MAZEN DIAB
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
17495 LA GRANGE RD, TINLEY PARK, IL 60487-7581
(630) 873-8875
Mailing address
1860 PAYSHERE CIR, CHICAGO, IL 60674-4325
(630) 469-9200
Taxonomy
Speciality
Code
Description
License number
State
207PT0002X
Medical Toxicology (Emergency Medicine) Physician
MT198421
PA
207R00000X
Internal Medicine Physician
036135420
IL
207RN0300X
Nephrology Physician
Primary
036-135420
IL
Other
Enumeration date
09/02/2010
Last updated
03/30/2017
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