Provider Demographics
NPI:1700221579
Name:MARZEC'S SPECS, P.C.
Entity Type:Organization
Organization Name:MARZEC'S SPECS, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:PAMELA
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:MARZEC
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:847-242-1692
Mailing Address - Street 1:14139 RADO DR W
Mailing Address - Street 2:
Mailing Address - City:HOMER GLEN
Mailing Address - State:IL
Mailing Address - Zip Code:60491-8151
Mailing Address - Country:US
Mailing Address - Phone:847-242-1692
Mailing Address - Fax:847-330-2236
Practice Address - Street 1:2 WOODFIELD MALL
Practice Address - Street 2:
Practice Address - City:SCHAUMBURG
Practice Address - State:IL
Practice Address - Zip Code:60173-5012
Practice Address - Country:US
Practice Address - Phone:847-242-1692
Practice Address - Fax:847-330-2236
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-07
Last Update Date:2014-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL046010627152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILIL8869Medicare PIN