Organization
FIRDAUSI F. MAZDA, M.D.,S.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. FIRDAUSI F MAZDA M.D. (PRESIDENT)
(630) 941-2646
Entity
Organization
Contact information
Practice address
360 W BUTTERFIELD RD, #245, ELMHURST, IL 60126-5068
(630) 941-2646
(630) 941-3464
Mailing address
PO BOX 66974, SLOT L, CHICAGO, IL 60666-0974
(630) 941-2646
(630) 941-3464
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0360534593
—
IL
Enumeration date
02/22/2007
Last updated
08/22/2020
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