Maze, Jelica
Maze, Jelica is an individual health care provider with primary practice located at 12750 St Francis Dr Ste 320 , Crown Point IN 46307-0264. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Cardiovascular Disease. Allopathic & Osteopathic Physicians / Cardiovascular Disease is her primary health care specialty. Maze, Jelica can be contacted via phone (219) 662-0077.Contact Information
Primary practice address
12750 St Francis Dr Ste 320
Crown Point IN 46307-0264
Phone: (219) 662-0077
Fax: (219) 662-9496
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | 01077479A | Indiana |
| Allopathic & Osteopathic Physicians / Cardiovascular Disease | 207RC0000X | MD445339 | Pennsylvania |
| Allopathic & Osteopathic Physicians / Cardiovascular Disease | 207RC0000X | ME112860 | Florida |
| Allopathic & Osteopathic Physicians / Cardiovascular Disease | 207RC0000X | 036132452 | Illinois |
| Allopathic & Osteopathic Physicians / Cardiovascular Disease | 207RC0000X | 01077479A | Indiana |
Profile Details
| NPI number | 1811162704 |
|---|---|
| LBN Legal business name | Maze, Jelica |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Apr 23rd, 2008 |
| Last updated | Jan 12th, 2024 - about 11 months ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1811162704 | NPPES |
| Illinois | MEDICAID | 036132452 | |
| Illinois | Other | 1124399605 |
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