Individual
MAX MAIZELS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2300 N CHILDRENS PLZ, CHICAGO, IL 60614-3363
(630) 789-2550
Mailing address
35422 EAGLE WAY, CHICAGO, IL 60678-1354
Taxonomy
Speciality
Code
Description
License number
State
2086S0120X
Pediatric Surgery Physician
Primary
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1627123
BCBS PROVIDER ID
IL
Enumeration date
09/16/2005
Last updated
07/08/2007
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