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NPI 1932260171

NPI 1932260171 : JOSEPH D. ZIZZO O.D. : PALATINE, IL

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General NPI Number Information
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    NPI Number           |    1932260171
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    Entity Type          |    Individual 
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    Provider Name        |    JOSEPH D. ZIZZO O.D.
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    12/12/2006
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    Last Update Date     |    07/08/2007
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Provider Practice Location Address
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    Address Line         |    1590 N RAND RD #K
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    City                 |    PALATINE
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    State                |    IL
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    Zip                  |    60074-8510
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    Country              |    US
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    Telephone            |    847-934-7616
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    Fax                  |    847-934-7686
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Provider Business Mailing Address
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    Address Line         |    1590 N RAND RD #K
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    City                 |    PALATINE
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    State                |    IL
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    Zip                  |    60074-8510
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    Country              |    US
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    Telephone            |    847-934-7616
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    Fax                  |    847-934-7686
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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        |    152W00000X
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    Taxonomy Name        |    Optometrist
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    License Number       |    046007725
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    License Number State |    IL
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