Active NPI
Edmund Walter Vizinas, M.D.
- Internal Medicine Physician
- Chicago, IL
National Provider Identifier
1922178391
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 036-159443
- Practice address
- 6918 W Archer Ave
3 And 4
Chicago, IL 60638-2337 - Phone
- (773) 229-9965
- Fax
- (773) 229-9849
- NPI assigned
- Nov 9, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 036-159443 | IL | Primary |
Addresses
Primary practice location
6918 W Archer Ave
3 And 4
Chicago, IL 60638-2337
Mailing address
6918 W Archer Ave
3 And 4
Chicago, IL 60638-2337
Phone (773) 229-9965
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| CD7818 | Other | IL | MEDICARE RR |
| 1710102660 | Other | IL | MEDICARE ID-TYPE UNSPECIFIED |
| 363326542 | Other | IL | TRICARE |
| 1710102660 | Other | IL | BCBS |
| 036059443 | Medicaid | IL |
Other names 1
- Mrs. Grazina Rita Vizinas
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036-159443 | IL | MD | Internal Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1163030400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1277251200000",
"number": "1922178391",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6918 W ARCHER AVE",
"address_2": "3 AND 4",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606382337",
"telephone_number": "773-229-9965",
"fax_number": "773-229-9849"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6918 W ARCHER AVE",
"address_2": "3 AND 4",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606382337",
"telephone_number": "773-229-9965",
"fax_number": "773-229-9849"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VIZINAS",
"first_name": "EDMUND",
"middle_name": "WALTER",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-11-09",
"last_updated": "2010-06-23",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "IL",
"license": "036-159443",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE RR",
"identifier": "CD7818",
"state": "IL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE ID-TYPE UNSPECIFIED",
"identifier": "1710102660",
"state": "IL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TRICARE",
"identifier": "363326542",
"state": "IL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "1710102660",
"state": "IL"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "036059443",
"state": "IL"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "GRAZINA",
"last_name": "VIZINAS",
"middle_name": "RITA",
"prefix": "MRS.",
"credential": "RN",
"code": "2",
"type": "Professional Name"
}
]
}Other providers in Chicago, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.