JENNIFER ROSE DEFAZIO

CHICAGO, IL
NPI1235441429
Former NameJENNIFER ROSE MIKSAN
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy2086S0120X Surgery Pediatric Surgery
(Licence: NY  288868-1)
Enumeration Date2010-07-05
Last Update Date2020-01-23
Business Address
JENNIFER ROSE DEFAZIO M.D.
5841 S MARYLAND AVE
CHICAGO, IL 60637-1447
Phone number: 773-702-1000
Mailing Address
JENNIFER ROSE DEFAZIO M.D.
3959 BROADWAY RM 216B
NEW YORK, NY 10032-1559
Phone number:
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