Provider Demographics
NPI:1992273056
Name:RAZO, DONIZETTI (MSW)
Entity type:Individual
Prefix:
First Name:DONIZETTI
Middle Name:
Last Name:RAZO
Suffix:
Gender:M
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5000 S. FIFTH AVENUE
Mailing Address - Street 2:BUILDING 228, ROOM 4078
Mailing Address - City:HINES
Mailing Address - State:IL
Mailing Address - Zip Code:60141
Mailing Address - Country:US
Mailing Address - Phone:708-202-4945
Mailing Address - Fax:708-202-4954
Practice Address - Street 1:5000 S. FIFTH AVENUE
Practice Address - Street 2:BUILDING 228, ROOM 4078
Practice Address - City:HINES
Practice Address - State:IL
Practice Address - Zip Code:60141
Practice Address - Country:US
Practice Address - Phone:708-202-4945
Practice Address - Fax:708-202-4954
Is Sole Proprietor?:Yes
Enumeration Date:2018-11-07
Last Update Date:2018-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker