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General NPI Number Information
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NPI Number | 1770654667
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Entity Type | Individual
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Provider Name | MR. MICHAEL BURZIC
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Gender | Male
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Dates
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Enumeration Date | 11/13/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1ST. AVE 1 BLK N OF CERMAK BLDG 37 RM 139 DEPARTMENT OF VETERANS AFFAIRS PBMEPS
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City | HINES
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State | IL
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Zip | 60141
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Country | US
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Telephone | 708-786-7973
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Fax |
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Provider Business Mailing Address
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Address Line | 5931 N DRAKE AVE
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City | CHICAGO
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State | IL
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Zip | 60659-3202
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Country | US
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Telephone | 773-463-4982
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Fax |
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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 | 183500000X
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Taxonomy Name | Pharmacist
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License Number |
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License Number State | IL
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