Basic Information
| Provider Information | |||||||||
| NPI: | 1790876829 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | PRZYPYSZNY | ||||||||
| FirstName: | JOHN | ||||||||
| MiddleName: | C | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 222 E DUNDEE RD | ||||||||
| Address2: | JOHN C PRZYPYSZNY MD | ||||||||
| City: | WHEELING | ||||||||
| State: | IL | ||||||||
| PostalCode: | 60090 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8475200235 | ||||||||
| FaxNumber: | 8475200390 | ||||||||
| Practice Location | |||||||||
| Address1: | 2222 W DIVISION ST | ||||||||
| Address2: | STE 225 | ||||||||
| City: | CHICAGO | ||||||||
| State: | IL | ||||||||
| PostalCode: | 60622 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7737250522 | ||||||||
| FaxNumber: | 7732520012 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/27/2006 | ||||||||
| LastUpdateDate: | 01/29/2008 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208600000X | 036032863 | IL | Y | Allopathic & Osteopathic Physicians | Surgery |
ID Information
| ID | Type | State | Issuer | Description | 036032863 | 05 | IL | MEDICAID |