Individual
DR. ANDREW MAZULIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
825 S MILWAUKEE AVE, LIBERTYVILLE, IL 60048-3218
(847) 573-2845
Mailing address
29373 NETWORK PL, CHICAGO, IL 60673-1293
(847) 390-5900
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
1699031583
IL
207RG0100X
Gastroenterology Physician
Primary
036-135984
IL
207RG0100X
Gastroenterology Physician
69801-20
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1699031583
—
WI
01
—
69801-20
LICENSE
WI
Enumeration date
04/05/2012
Last updated
01/05/2024
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