Provider Demographics
NPI:1639845845
Name:BUZZIO, OSCAR (RPH)
Entity Type:Individual
Prefix:
First Name:OSCAR
Middle Name:
Last Name:BUZZIO
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1856 N MOZART ST
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60647-5112
Mailing Address - Country:US
Mailing Address - Phone:414-630-2431
Mailing Address - Fax:
Practice Address - Street 1:8639 S CICERO AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60652-3505
Practice Address - Country:US
Practice Address - Phone:773-284-6332
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-18
Last Update Date:2021-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI15992-40183500000X
IL051.298321183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist