Thomas R. Mizen, M.D. and Associates, LLC

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

036062834 Issued in IL

Legal business name

THOMAS R. MIZEN, M.D. AND ASSOCIATES, LLC

Practice address

6187 S Archer Ave
Suite 101
Chicago, IL 60638-2605

Phone

(773) 581-2000

Fax

(773) 581-2878

NPI assigned

Apr 3, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Thomas R Mizen, M.D.

Title

Manager

Phone

(773) 581-2000

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1175558400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1354147200000",
    "number": "1659492759",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6187 S ARCHER AVE",
            "address_2": "SUITE 101",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606382605",
            "telephone_number": "773-581-2000",
            "fax_number": "773-581-2878"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6187 S ARCHER AVE",
            "address_2": "SUITE 101",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606382605",
            "telephone_number": "773-581-2000",
            "fax_number": "773-581-2878"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THOMAS R. MIZEN, M.D. AND ASSOCIATES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-03",
        "last_updated": "2012-11-29",
        "status": "A",
        "authorized_official_last_name": "MIZEN",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "773-581-2000",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": "IL",
            "license": "036062834",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Ophthalmology Physician in Chicago, IL
• Providers in Chicago, IL by specialty
• Ophthalmology Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.