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Individual

FIRDAUSI F MAZDA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
360 W BUTTERFIELD RD, STE 245, ELMHURST, IL 60126-5068
(630) 941-2646
(630) 941-3464
Mailing address
360 W BUTTERFIELD RD, STE 245, ELMHURST, IL 60126-5068
(630) 941-2646
(630) 941-3464

Taxonomy

Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
036-053459
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0360534593
IL
Enumeration date
01/10/2006
Last updated
12/10/2013
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