Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RP1001X | Pulmonary Disease | IL |
NPI | 1023019940 |
---|---|
Provider Name | Dr. Tony Cazeau |
First Address | Hinsdale, IL 60521-4377 |
Second Address | Chicago, IL 60624-3312 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 02/08/2005 |
Last Update Date | 15/04/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
2233374 | BLUE CROSS BLUE SHIELD (01) | IL |
N253212 | HARMONY HEALTH PLAN (01) | IL |