Individual
SAMUEL PORIZA AU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
301 N 8TH ST, SPRINGFIELD, IL 62701-1041
(217) 525-5666
(217) 757-6754
Mailing address
301 N 8TH ST, SPRINGFIELD, IL 62701-1041
(217) 525-5666
(217) 757-6754
Taxonomy
Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
Primary
036117479
IL
2085R0001X
Radiation Oncology Physician
13493
NV
2085R0001X
Radiation Oncology Physician
35081855
OH
2085R0001X
Radiation Oncology Physician
ME114482
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
007934500
—
FL
05
—
1578565420
—
NV
01
—
1624235
GHI
NV
05
—
2368816
—
OH
05
—
543382
—
AZ
01
—
6054447
CIGNA
NV
01
—
880457
USA MCO
NV
01
—
GV509Z
MEDICARE
FL
01
—
P00885629
RAILROAD MEDICARE
NV
Enumeration date
08/11/2005
Last updated
10/19/2015
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