Organization
EDMUND W VIZINAS, MD SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. EDMUND WALTER VIZINAS M.D. (OWNER)
(773) 229-9965
Entity
Organization
Contact information
Practice address
6918 W ARCHER AVE, SUITE 4, CHICAGO, IL 60638-2337
(773) 229-9965
(773) 229-9849
Mailing address
6918 W ARCHER AVE, SUITE 4, CHICAGO, IL 60638-2337
(773) 229-9965
(773) 229-9849
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
0
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
31600576
BCBS
IL
Enumeration date
04/16/2007
Last updated
07/21/2022
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