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Individual

JUDITH LOUISE MAZION

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
DC

Contact information

Practice address
105 TERRACE CT, SOMONAUK, IL 60552-9700
(815) 498-2308
Mailing address
105 TERRACE CT, SOMONAUK, IL 60552-9700
(815) 498-2308

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
CH2383
FL
111N00000X
Chiropractor
Primary
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
01915187
BCBS
IL
Enumeration date
06/28/2006
Last updated
11/05/2007
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