Provider Demographics
NPI:1285711697
Name:PIZZURRO, ROBERT E (DDS)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:E
Last Name:PIZZURRO
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1816 BAY SCOTT CIR STE 104
Mailing Address - Street 2:
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60540-1113
Mailing Address - Country:US
Mailing Address - Phone:630-355-5010
Mailing Address - Fax:630-355-4317
Practice Address - Street 1:1816 BAY SCOTT CIR STE 104
Practice Address - Street 2:
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60540-1113
Practice Address - Country:US
Practice Address - Phone:630-355-5010
Practice Address - Fax:630-344-4317
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-01
Last Update Date:2021-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL19A143901223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILT37842Medicare UPIN
IL62959Medicare ID - Type Unspecified