Individual
ROBERT J DIZES JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
1414 CROSS ST STE 230, SHILOH, IL 62269-2988
(618) 607-1260
Mailing address
1414 CROSS ST STE 230, SHILOH, IL 62269-2988
(618) 607-1260
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
085001206
IL
363AM0700X
Medical Physician Assistant
085001206
IL
Other
Enumeration date
10/02/2006
Last updated
08/19/2022
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