Provider Demographics
NPI:1952171001
Name:CZAPKO, CALVIN ZANE CREMENT
Entity Type:Individual
Prefix:
First Name:CALVIN
Middle Name:ZANE CREMENT
Last Name:CZAPKO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8900 31ST ST UNIT 7
Mailing Address - Street 2:
Mailing Address - City:BROOKFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:60513-1473
Mailing Address - Country:US
Mailing Address - Phone:630-660-2368
Mailing Address - Fax:
Practice Address - Street 1:77 WARREN ST # B
Practice Address - Street 2:
Practice Address - City:BRIGHTON
Practice Address - State:MA
Practice Address - Zip Code:02135-3601
Practice Address - Country:US
Practice Address - Phone:617-787-1901
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-08
Last Update Date:2024-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program