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Contact Information

MARY FAZELIAN, OD
7305 W IRVING PARK RD
CHICAGO, IL60634-3547
 Phone: 847-722-8319
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Optometrist

152W00000X 41 Optometry
 

Occupational Vision

152WX0102X 41 Optometry
Indicates primary specialty

NPI Profile & details for MARY FAZELIAN · (Female)

NPI # 1801914007
Status Active
Credentials OD (Doctor of Optometry)
Entity Individual
Enumeration date 03/26/2007
Last updated 05/22/2012 - About 14 years ago
Sole proprietor 1 No
Identifiers
  • IL License # 046009825
  • OR License # 3190 AT
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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