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Organization
GIZUNT SC
Active
Organization
GIZUNT SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PETER SMITH (CREDENTIALING AGENT)
(815) 965-8505
Entity
Organization
Contact information
Practice address
5929 N CICERO AVE, CHICAGO, IL 60646-5701
(773) 529-4913
Mailing address
293 WOODSTONE CIR, BUFFALO GROVE, IL 60089-6702
(847) 459-8563
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
036111300
IL
Other
Enumeration date
02/23/2007
Last updated
08/07/2014
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