Provider Demographics
NPI:1649382334
Name:TRYZNO, JOZEF (MD, RVT)
Entity Type:Individual
Prefix:
First Name:JOZEF
Middle Name:
Last Name:TRYZNO
Suffix:
Gender:M
Credentials:MD, RVT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:760 BUSSE HWY
Mailing Address - Street 2:
Mailing Address - City:PARK RIDGE
Mailing Address - State:IL
Mailing Address - Zip Code:60068-2402
Mailing Address - Country:US
Mailing Address - Phone:847-518-9999
Mailing Address - Fax:847-518-2288
Practice Address - Street 1:760 BUSSE HWY
Practice Address - Street 2:
Practice Address - City:PARK RIDGE
Practice Address - State:IL
Practice Address - Zip Code:60068-2402
Practice Address - Country:US
Practice Address - Phone:847-518-9999
Practice Address - Fax:847-518-2288
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2009-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036089963207Q00000X, 202K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes202K00000XAllopathic & Osteopathic PhysiciansPhlebology
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILO1625643OtherBCBS PROVIDER NUMBER
IL39089963Medicaid
ILG16628Medicare UPIN
IL408890Medicare PIN