Provider Demographics
NPI:1639133358
Name:AZIZ, GEORGE F (MD)
Entity Type:Individual
Prefix:DR
First Name:GEORGE
Middle Name:F
Last Name:AZIZ
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 1:13011 S 104TH AVE STE 100
Mailing Address - Street 2:
Mailing Address - City:PALOS PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60464-1508
Mailing Address - Country:US
Mailing Address - Phone:708-478-3600
Mailing Address - Fax:708-478-3552
Practice Address - Street 1:195 SPRINGFIELD AVE UNIT 201
Practice Address - Street 2:
Practice Address - City:JOLIET
Practice Address - State:IL
Practice Address - Zip Code:60435-6526
Practice Address - Country:US
Practice Address - Phone:815-823-8200
Practice Address - Fax:815-823-8201
Is Sole Proprietor?:No
Enumeration Date:2006-04-12
Last Update Date:2020-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036101060207RC0000X, 207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILCD8033OtherRAILROAD MEDICAR GROUP PTAN NUMBER
IL236550OtherMEDICARE GROUP
IL236551OtherMEDICARE GROUP
ILCN2703OtherRAILROAD MEDICARE GROUP PTAN NUMBER
ILP00233149OtherRAILROAD MEDICARE WILL
IL416810OtherMEDICARE GROUP
IL01621208OtherBLUECROSS BLUE SHIELD
IL1508810086OtherGROUP NPI
ILCG1672OtherRAILROAD MEDICARE GROUP PTAN NUMBER
IL036101060Medicaid
ILP00235000OtherRAILROAD MEDICARE COOK
ILP00300772OtherRAILROAD MEDICARE KANKAKE
ILCD8033OtherRAILROAD MEDICAR GROUP PTAN NUMBER
H99839Medicare UPIN
IL416810OtherMEDICARE GROUP
ILP00233149OtherRAILROAD MEDICARE WILL