Individual
JOHN MADDALOZZO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
225 E. CHICAGO AVE., #25, ANN & ROBERT H. LURIE CHILDREN'S HOSPITAL OF CHICAGO, CHICAGO, IL 60611-2605
(312) 227-6230
Mailing address
225 E. CHICAGO AVE., #25, ANN & ROBERT H. LURIE CHILDREN'S HOSPITAL OF CHICAGO, CHICAGO, IL 60611-2605
(312) 227-6230
Taxonomy
Speciality
Code
Description
License number
State
207YP0228X
Pediatric Otolaryngology Physician
Primary
036-065457
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036065457
—
IL
01
—
1627123
BCBS PROVIDER ID
IL
05
—
2386216
—
OH
Enumeration date
09/20/2005
Last updated
04/17/2013
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