Provider Demographics
NPI:1164823696
Name:GYUZELEV, PETAR (MD, RSA)
Entity Type:Individual
Prefix:DR
First Name:PETAR
Middle Name:
Last Name:GYUZELEV
Suffix:
Gender:M
Credentials:MD, RSA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:314 WILMINGTON CT
Mailing Address - Street 2:
Mailing Address - City:WOODSTOCK
Mailing Address - State:IL
Mailing Address - Zip Code:60098-7859
Mailing Address - Country:US
Mailing Address - Phone:815-307-5005
Mailing Address - Fax:815-307-5005
Practice Address - Street 1:314 WILMINGTON CT
Practice Address - Street 2:
Practice Address - City:WOODSTOCK
Practice Address - State:IL
Practice Address - Zip Code:60098-7859
Practice Address - Country:US
Practice Address - Phone:815-307-5005
Practice Address - Fax:815-307-5005
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-16
Last Update Date:2023-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Assistant