Jennifer Rose Defazio
Pediatric Surgery
5841 S Maryland Ave
Chicago
, Illinois 60637-1447
Jennifer Rose Defazio
Pediatric Surgery
5841 S Maryland Ave
Chicago
, Illinois 60637-1447
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About
Features
Specialties
- Pediatric Surgery
Languages spoken
- English
Location
First Address
- Jennifer Rose Defazio
- 3959 Broadway Rm 216b
- New York, NY
- Zip : 10032-1559
- Phone :
Second Address
- Jennifer Rose Defazio
- 5841 S Maryland Ave
- Chicago, IL
- Zip : 60637-1447
- Phone : (773) 702-1000
Reviews
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 2086S0120X | Pediatric Surgery | 288868-1 | NY |
National Provider Identifier
| NPI | 1235441429 |
|---|---|
| Provider Name | Jennifer Rose Defazio |
| First Address | New York, NY 10032-1559 |
| Second Address | Chicago, IL 60637-1447 |
| Gender | F |
| NPI Entity type | Individual |
| Is Sole Proprietor | Yes |
| Is Organization Subpart | N/A |
| Enumeration Date | 05/07/2010 |
| Last Update Date | 23/01/2020 |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.