Provider Demographics
NPI:1255327102
Name:SZABO, SZABOLCS (MD)
Entity Type:Individual
Prefix:DR
First Name:SZABOLCS
Middle Name:
Last Name:SZABO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17850 KEDZIE AVE STE 3250
Mailing Address - Street 2:
Mailing Address - City:HAZEL CREST
Mailing Address - State:IL
Mailing Address - Zip Code:60429-2082
Mailing Address - Country:US
Mailing Address - Phone:708-799-8700
Mailing Address - Fax:708-957-1830
Practice Address - Street 1:17850 KEDZIE AVE STE 3250
Practice Address - Street 2:
Practice Address - City:HAZEL CREST
Practice Address - State:IL
Practice Address - Zip Code:60429-2082
Practice Address - Country:US
Practice Address - Phone:708-799-8700
Practice Address - Fax:708-957-1830
Is Sole Proprietor?:No
Enumeration Date:2005-09-26
Last Update Date:2021-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01053987207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200352710Medicaid
IN200352710Medicaid
IN192820 QMedicare ID - Type Unspecified
IN707880Medicare PIN
IN878190FMedicare PIN
IN169910EMedicare PIN
IN221020CMedicare PIN
IN169950DMedicare PIN