Provider Demographics
NPI:1073011821
Name:RIZZO, ANDREA MARIE (APN)
Entity Type:Individual
Prefix:
First Name:ANDREA
Middle Name:MARIE
Last Name:RIZZO
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19W235 GINGER BROOK DR N
Mailing Address - Street 2:
Mailing Address - City:OAK BROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60523-1022
Mailing Address - Country:US
Mailing Address - Phone:630-479-8273
Mailing Address - Fax:708-398-6870
Practice Address - Street 1:805 OGDEN AVE
Practice Address - Street 2:
Practice Address - City:LISLE
Practice Address - State:IL
Practice Address - Zip Code:60532-1337
Practice Address - Country:US
Practice Address - Phone:331-903-1759
Practice Address - Fax:708-246-1109
Is Sole Proprietor?:No
Enumeration Date:2018-01-26
Last Update Date:2021-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209016633363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily