Organization
DRS LUCKHARDT AND MAZE LTD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DAVID A. MAZE O.D.. (OWNER)
(630) 969-2807
Entity
Organization
Contact information
Practice address
136 N. CASS AVE, WESTMONT, IL 60559
(630) 969-2807
(630) 969-2894
Mailing address
136 N. CASS AVE, WESTMONT, IL 60559
(630) 969-2807
(630) 969-2894
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
060008794
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
211370
PTAN
IL
Enumeration date
03/16/2007
Last updated
04/09/2010
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