Provider Demographics
NPI:1598852832
Name:TRIZZINO, CURT PAUL (MSHSA)
Entity Type:Individual
Prefix:MR
First Name:CURT
Middle Name:PAUL
Last Name:TRIZZINO
Suffix:
Gender:M
Credentials:MSHSA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:528 SAN CARLOS RD
Mailing Address - Street 2:
Mailing Address - City:MINOOKA
Mailing Address - State:IL
Mailing Address - Zip Code:60447-9245
Mailing Address - Country:US
Mailing Address - Phone:815-467-5874
Mailing Address - Fax:
Practice Address - Street 1:122 DEPOT
Practice Address - Street 2:
Practice Address - City:GARDNER
Practice Address - State:IL
Practice Address - Zip Code:60424
Practice Address - Country:US
Practice Address - Phone:815-237-2152
Practice Address - Fax:815-237-0858
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist