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Joseph Canzona Dds Md Ltd
Medical Specialty Clinic/Center in Evanston, Illinois
NPI 1104099324

Joseph Canzona Dds Md Ltd is a Medical Specialty Clinic/Center based in Evanston, IL and is specialized in Medical Specialty. Joseph Canzona Dds Md Ltd practices in Evanston, IL. The NPI Number for Joseph Canzona Dds Md Ltd is 1104099324 and holds a License No. 36064858 (Illinois).

The current practice location address for Joseph Canzona Dds Md Ltd is 2500 Ridge Avenue, Evanston, IL and can be reached out via phone at 847-328-8899 and via fax at 847-328-3545.

Location: 2500 Ridge Avenue, Evanston, IL, 60201-2477
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1104099324
Provider Name
Joseph Canzona Dds Md Ltd
Credential
Provider Entity Type
Organization
Address
2500 Ridge Avenue, Evanston, IL, 60201-2477
Phone Number
847-328-8899
Fax Number
847-328-3545
Provider Enumeration Date
04/09/2008
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
2500 Ridge Avenue
City
Evanston
State
Illinois
Zip
60201-2477
Phone Number
847-328-8899
Fax Number
847-328-3545
person
Provider Business Mailing Address Details
Address
2500 Ridge Avenue
City
Evanston
State
Illinois
Zip
60201-2477
Phone Number
847-328-8899
Fax Number
847-328-3545
person
Provider's Taxonomy Details 1
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
Medical Specialty
Taxonomy
261QM2500X
License No.
36064858 (Illinois)
Definition
An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to a specific area of medical specialization. Frequently used for Title V related Children's Specialty services or to meet specific public health needs (e.g., infectious diseases or breast and cervical cancer).
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