Provider Demographics
NPI:1932230604
Name:MAZZINI, MARIA REGINA (MED)
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:REGINA
Last Name:MAZZINI
Suffix:
Gender:F
Credentials:MED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2400 TRILLIUM LN
Mailing Address - Street 2:
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60565-5209
Mailing Address - Country:US
Mailing Address - Phone:312-545-8111
Mailing Address - Fax:
Practice Address - Street 1:2400 TRILLIUM LN
Practice Address - Street 2:
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60565-5209
Practice Address - Country:US
Practice Address - Phone:312-545-8111
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225800000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRecreation Therapist