Individual
JOSEPH FRAZZETTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2160 S 1ST AVE, MAYWOOD, IL 60153-3328
(888) 584-7888
Mailing address
722 N ELIZABETH ST APT 1, CHICAGO, IL 60642-0030
(314) 852-2252
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
NONE
—
IL
Enumeration date
03/24/2021
Last updated
03/24/2021
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