Organization
THOMAS R. MIZEN, M.D. AND ASSOCIATES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
THOMAS R MIZEN M.D. (MANAGER)
(773) 581-2000
Entity
Organization
Contact information
Practice address
6187 S ARCHER AVE, SUITE 101, CHICAGO, IL 60638-2605
(773) 581-2000
(773) 581-2878
Mailing address
6187 S ARCHER AVE, SUITE 101, CHICAGO, IL 60638-2605
(773) 581-2000
(773) 581-2878
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
036062834
IL
Other
Enumeration date
04/03/2007
Last updated
11/29/2012
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