Individual
SAM MARZO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2160 S 1ST AVE, MAGUIRE CENTER 1870, MAYWOOD, IL 60153-3328
(708) 216-9183
(708) 216-4834
Mailing address
2160 S 1ST AVE, MAGUIRE CENTER 1870, MAYWOOD, IL 60153-3328
(708) 216-9183
(708) 216-4834
Taxonomy
Speciality
Code
Description
License number
State
207YX0901X
Otology & Neurotology Physician
Primary
036-088744
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
263532
MEDICARE
IL
05
—
36088744
—
IL
Enumeration date
12/30/2005
Last updated
06/17/2011
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