Provider Demographics
NPI:1295521102
Name:RIZVI MD DIRECT PLLC
Entity type:Organization
Organization Name:RIZVI MD DIRECT PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:
Authorized Official - First Name:SYED
Authorized Official - Middle Name:
Authorized Official - Last Name:RIZVI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:267-760-5168
Mailing Address - Street 1:7210 E STATE ST STE 107
Mailing Address - Street 2:
Mailing Address - City:ROCKFORD
Mailing Address - State:IL
Mailing Address - Zip Code:61108-2636
Mailing Address - Country:US
Mailing Address - Phone:779-256-7075
Mailing Address - Fax:
Practice Address - Street 1:7210 E STATE ST STE 107
Practice Address - Street 2:
Practice Address - City:ROCKFORD
Practice Address - State:IL
Practice Address - Zip Code:61108-2636
Practice Address - Country:US
Practice Address - Phone:779-256-7075
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-04-17
Last Update Date:2025-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty