Individual
MS. MISHELLE A. MAZZONE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
P.T.
Contact information
Practice address
10308 LYMAN AVE, 3N, CHICAGO RIDGE, IL 60415-1687
(708) 209-9509
Mailing address
10308 LYMAN AVE, 3N, CHICAGO RIDGE, IL 60415-1687
(708) 209-9509
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
070005096
IL
Other
Enumeration date
01/26/2009
Last updated
01/26/2009
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