Provider Demographics
NPI:1356404420
Name:MILZER, MARY E (OD)
Entity type:Individual
Prefix:
First Name:MARY
Middle Name:E
Last Name:MILZER
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:810 KINGSBRIDGE WAY
Mailing Address - Street 2:
Mailing Address - City:BUFFALO GROVE
Mailing Address - State:IL
Mailing Address - Zip Code:60089-1030
Mailing Address - Country:US
Mailing Address - Phone:847-913-1614
Mailing Address - Fax:
Practice Address - Street 1:850 E GOLF RD
Practice Address - Street 2:
Practice Address - City:SCHAUMBURG
Practice Address - State:IL
Practice Address - Zip Code:60173-4502
Practice Address - Country:US
Practice Address - Phone:847-259-3933
Practice Address - Fax:847-259-7211
Is Sole Proprietor?:No
Enumeration Date:2006-12-19
Last Update Date:2010-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL046-007306152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL153587Medicare UPIN
IL57927001Medicare PIN