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General NPI Number Information
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NPI Number | 1669447272
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Entity Type | Individual
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Provider Name | NICHOLAS RIZZO M.D.
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Gender | Male
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Dates
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Enumeration Date | 02/18/2006
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Last Update Date | 03/19/2024
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Provider Practice Location Address
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Address Line | 615 N MICHIGAN ST FL 1
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City | SOUTH BEND
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State | IN
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Zip | 46601-1033
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Country | US
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Telephone | 574-647-3050
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Fax | 574-647-1094
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Provider Business Mailing Address
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Address Line | 7270 W. COLLEGE DRIVE SUITE 102
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City | PALOS HEIGHTS
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State | IL
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Zip | 60463-1180
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Country | US
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Telephone | 708-603-5980
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Fax | 708-589-9059
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 01092630A
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License Number State | IN
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | S4223
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License Number State | TX
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Taxonomy #3
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 61331
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License Number State | TN
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Taxonomy #4
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 036095309
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License Number State | IL
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