DR. MICHAEL CAREY DEFAZIO (NPI# 1497189476) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1497189476 |
| Entity Type | Individual |
| Full Name | DR. MICHAEL CAREY DEFAZIO |
| Credential | D.D.S. |
| Practice Address |
3001 Green Bay Rd Fisher Dental Clinic North Chicago IL 60064-3048 |
| Practice Telephone | 8476883331 |
| Mailing Telephone | 8476883331 |
| Enumeration Date | 2013-08-27 |
| Last Update Date | 2013-08-27 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609367465 | Michael J Defazio | Driver | 6755 Shelter Ln, Las Vegas, NV 89103-4369 | 2018-05-28 |
| 1821354325 | Michael Vincent Defazio | Surgery | 14546 Old Saint Augustine Rd Ste 407, Jacksonville, FL 32258-5473 | 2012-04-09 |
| 1154407419 | Michael A Defazio | Counselor | 3734 7th Ave, Ste 24, Kenosha, WI 53140 | 2006-10-30 |
| Street Address |
3001 GREEN BAY RD FISHER DENTAL CLINIC |
| City | NORTH CHICAGO |
| State | IL |
| Zip Code | 60064-3048 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386640290 | Shakira Ife Brown | Pharmacist | 3001 Green Bay Rd, North Chicago, IL 60064-3048 | 2005-06-24 |
| 1023628609 | Michelle Therese Dubil | Social Worker | 3001 Green Bay Rd, North Chicago, IL 60064-3048 | 2020-08-07 |
| 1710504758 | Todd David Johnson | Student in an Organized Health Care Education/Training Program | 3001 Green Bay Rd, North Chicago, IL 60064-3048 | 2020-06-25 |
| 1033735022 | Piotr Pawel Krolikowski | Internal Medicine | 3001 Green Bay Rd, North Chicago, IL 60064-3048 | 2020-06-25 |
| 1457977555 | Cortney Muns | Clinical Nurse Specialist | 3001 Green Bay Rd, North Chicago, IL 60064-3048 | 2020-06-24 |
| 1962028241 | Samantha Lynn Tuminaro | Social Worker | 3001 Green Bay Rd, North Chicago, IL 60064-3048 | 2020-06-22 |
| 1003432485 | Sara Elise Ringle | Registered Nurse | 3001 Green Bay Rd, North Chicago, IL 60064-3048 | 2020-06-22 |
| 1609492065 | Kaylee Elizabeth Caniff | Pharmacist | 3001 Green Bay Rd, North Chicago, IL 60064-3048 | 2020-06-22 |
| 1821613761 | Ana R Tomlinson | Registered Nurse | 3001 Green Bay Rd, North Chicago, IL 60064-3048 | 2020-06-16 |
| 1760007702 | William Joel Shumaker | Registered Nurse | 3001 Green Bay Rd, North Chicago, IL 60064-3048 | 2020-06-16 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356964084 | Corbin Paul Edmondson | Student in an Organized Health Care Education/Training Program | 3333 Greenbay Rd, North Chicago, IL 60064 | 2020-05-28 |
| 1881247534 | Aravind Reddy Kuchkuntla | Internal Medicine | 333 Greenbay Road, North Chicago, IL 60064 | 2019-07-22 |
| 1447721121 | Elise Teichman | Nurse Practitioner | 3001 Green Bat Rd, North Chicago, IL 60064 | 2018-12-06 |
| 1841711397 | Abhinav Kumar Nadipalli | Internal Medicine | 3333 Greenbay Road, North Chicago, IL 60064 | 2017-07-05 |
| 1376082503 | A Plus Untited Taxi Limosine | Taxi | 1721 Sheridan Rd, Suite C, North Chicago, IL 60064 | 2017-02-21 |
| 1003351503 | Jacob S Lewis, Dmd, P.C. | Dentist | 2233 Greenbay Rd, North Chicago, IL 60064 | 2016-12-20 |
| 1730635095 | Siva Rama Krishna Cheetirala | Internal Medicine | Rosalind Franklin University of Medicine and Sciences, 3333 Green Bay Road, North Chicago, IL 60064 | 2016-08-28 |
| 1669869764 | Benjamin Pittman | Military Health Care Provider | Uss Tranquility (bhc 1007), Capt James A Lovell Federal Health Care Center, North Chicago, IL 60064 | 2015-04-16 |
| 1013315068 | Rene Garcia Cantu Jr. | Military Health Care Provider | Captain James A. Lovell Federal Health Care Center, 3001 Green Bay Road, North Chicago, IL 60064 | 2014-12-08 |
| 1134521669 | Seyed Kamran Hejazi Kenari | Internal Medicine | 3001 Green Bay Rd Bldg 133, North Chicago, IL 60064 | 2014-09-16 |
| Find all providers in zip 60064 | ||||
| Taxonomy Code | 390200000X |
| Grouping | Student, Health Care |
| Classification | Student in an Organized Health Care Education/Training Program |
| An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |
| Notes: [1/1/2005: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164046835 | Karan Pandher | Student in an Organized Health Care Education/Training Program | 3333 North Greenbay Road, North Chicago, IL 60088-6008 | 2020-05-29 |
| 1356964084 | Corbin Paul Edmondson | Student in an Organized Health Care Education/Training Program | 3333 Greenbay Rd, North Chicago, IL 60064 | 2020-05-28 |
| 1972131985 | Janhavi Mahesh Dhargalkar | Student in an Organized Health Care Education/Training Program | 814 18th St, North Chicago, IL 60064-2130 | 2020-03-27 |
| 1912505181 | Akshay Jain | Student in an Organized Health Care Education/Training Program | 3333 Green Bay Rd, North Chicago, IL 60064-3037 | 2020-10-11 |
| 1326654005 | Matthew Lee Diamond | Student in an Organized Health Care Education/Training Program | 3333 Green Bay Rd, North Chicago, IL 60064-3037 | 2020-09-18 |
| 1104430990 | Travis Clinton O'rear | Student in an Organized Health Care Education/Training Program | 3333 Green Bay Rd, North Chicago, IL 60064-3037 | 2020-08-31 |
| 1275145740 | Katie Springer | Student in an Organized Health Care Education/Training Program | 3333 Green Bay Rd, North Chicago, IL 60064-3037 | 2020-08-17 |
| 1023628039 | Lindsay Elizabeth Edwards | Student in an Organized Health Care Education/Training Program | 3333 Green Bay Rd, North Chicago, IL 60064-3095 | 2020-08-04 |
| 1376151498 | Daniel Chu | Student in an Organized Health Care Education/Training Program | 3333 Green Bay Rd, North Chicago, IL 60064-3037 | 2020-07-14 |
| 1336767292 | Marcus Laron Forward II | Student in an Organized Health Care Education/Training Program | 3333 Green Bay Rd, North Chicago, IL 60064-3037 | 2020-07-08 |
| Find all providers in NORTH CHICAGO | ||||
| City | NORTH CHICAGO |
| Zip Code | 60064 |
Please comment or provide details below to improve the information on DR. MICHAEL CAREY DEFAZIO.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.