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NPI Code Detail

MEDICARE: DR. ANTON GARAZHA MD

MEDICARE: DR. ANTON GARAZHA MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12085R0202XDiagnostic Radiology Physician036.176639IL
22085R0202XDiagnostic Radiology Physician2025000996MO

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1649892928
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ANTON GARAZHA MD
Provider Business Mailing Address
First Line : PO BOX 7412011
Second Line :
City : CHICAGO
State : IL
Zip : 60674-2011
Country : US
Telephone Number : 314-362-7200
Fax Number : 314-747-4189
Provider Business Practice Location Address
First Line : 1653 W CONGRESS PKWY
Second Line :
City : CHICAGO
State : IL
Zip : 60612-3833
Country : US
Telephone Number : 312-942-5000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/10/2020
Last Update Date : 06/01/2026

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