Provider Demographics
NPI:1568862340
Name:SPIZIRI, JAMES
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:
Last Name:SPIZIRI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:JAMES
Other - Middle Name:ROBIN
Other - Last Name:SPIZIRI
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RN
Mailing Address - Street 1:3004 GRAND AVE
Mailing Address - Street 2:
Mailing Address - City:WAUKEGAN
Mailing Address - State:IL
Mailing Address - Zip Code:60085-2321
Mailing Address - Country:US
Mailing Address - Phone:847-377-8120
Mailing Address - Fax:847-984-5691
Practice Address - Street 1:3004 GRAND AVE
Practice Address - Street 2:
Practice Address - City:WAUKEGAN
Practice Address - State:IL
Practice Address - Zip Code:60085-2321
Practice Address - Country:US
Practice Address - Phone:847-377-8120
Practice Address - Fax:847-984-5691
Is Sole Proprietor?:No
Enumeration Date:2014-08-28
Last Update Date:2014-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL041-311438163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse