# EDMUND W VIZINAS, MD SC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1710102660
- **Authorized official:** DR. EDMUND WALTER VIZINAS M.D. (OWNER)
- **Authorized official phone:** (773) 229-9965

## Contact information

- **Practice address:** 6918 W ARCHER AVE, SUITE 4, CHICAGO, IL 60638-2337
- **Practice address phone:** (773) 229-9965
- **Practice address fax:** (773) 229-9849
- **Mailing address:** 6918 W ARCHER AVE, SUITE 4, CHICAGO, IL 60638-2337
- **Mailing address phone:** (773) 229-9965
- **Mailing address fax:** (773) 229-9849

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207R00000X | Internal Medicine Physician | 0 | IL | Yes |

## Other

- **Enumeration date:** 04/16/2007
- **Last updated:** 07/21/2022