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NPI Code Detail

MEDICARE: DR. DAVID SCOTT PEZEN M.D.

MEDICARE:  DR. DAVID SCOTT PEZEN  M.D.
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
1207N00000XDermatology Physician036-091039IL

General Provider Information

NPI Number : 1801881313
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. DAVID SCOTT PEZEN M.D.
Provider Business Mailing Address
First Line : 360 W BUTTERFIELD RD
Second Line : SUITE #240
City : ELMHURST
State : IL
Zip : 60126-5068
Country : US
Telephone Number : 630-833-3222
Fax Number : 630-833-3277
Provider Business Practice Location Address
First Line : 360 W BUTTERFIELD RD
Second Line : SUITE #240
City : ELMHURST
State : IL
Zip : 60126-5068
Country : US
Telephone Number : 630-833-3222
Fax Number : 630-833-3277
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/12/2005
Last Update Date : 05/19/2008

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Directions to “ DR. DAVID SCOTT PEZEN M.D.” Practice Location

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