Individual
DR. DAVID A. MAZE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
136 N CASS AVE, WESTMONT, IL 60559-1604
(630) 969-2807
Mailing address
136 N CASS AVE, WESTMONT, IL 60559-1604
(630) 969-2807
(630) 969-2894
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
046009686
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5984120001
PTAN
IL
01
—
K16173
K NUMBER
IL
Enumeration date
09/02/2006
Last updated
04/09/2010
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