Provider Demographics
NPI:1194891036
Name:MACZKO AND ASSOCIATES LTD
Entity type:Organization
Organization Name:MACZKO AND ASSOCIATES LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MITCHELL
Authorized Official - Middle Name:ALLEN
Authorized Official - Last Name:MACZKO
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:847-398-1334
Mailing Address - Street 1:1112 E CENTRAL
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON HGTS
Mailing Address - State:IL
Mailing Address - Zip Code:60005
Mailing Address - Country:US
Mailing Address - Phone:847-398-1334
Mailing Address - Fax:847-398-3096
Practice Address - Street 1:1112 E CENTRAL
Practice Address - Street 2:
Practice Address - City:ARLINGTON HGTS
Practice Address - State:IL
Practice Address - Zip Code:60005
Practice Address - Country:US
Practice Address - Phone:847-398-1334
Practice Address - Fax:847-398-3096
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-24
Last Update Date:2019-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty