Canzona, Joseph E

Canzona, Joseph E is an individual health care provider with primary practice located at 2500 Ridge Ave Suite 302, Evanston IL 60201-2455. He recently has only one registered license in Dental Providers / Oral and Maxillofacial Surgery, which is considered as his primary health care specialty. Canzona, Joseph E can be contacted via phone (847) 328-8899.

Contact Information

Primary practice address
2500 Ridge Ave Suite 302 Evanston IL 60201-2455
Fax: (847) 328-3545
Website:

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Oral and Maxillofacial Surgery 1223S0112X 21-000762 Illinois
Dental Providers / Oral and Maxillofacial Surgery 1223S0112X 19-13567 Illinois
Dental Providers / Oral and Maxillofacial Surgery 1223S0112X 36-064858 Illinois

Profile Details

NPI number 1265411276
LBN Legal business name Canzona, Joseph E
Credentials DDS, MD
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 10th, 2006
Last updated Jul 22nd, 2008 - about 16 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1265411276 NPPES
Illinois Other TAX ID 36-3349069

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