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DR. JENNA MARIE LIZZO MD MA NPI 1972009124


NPI Information

NPI: 1972009124
Provider Name: DR. JENNA MARIE LIZZO, MD, MA
Classification: Student in an Organized Health Care Education/Training Program - 390200000X
Entity Type: Individual

PECOS Registration: Yes

Address:
530 NE GLEN OAK AVE
PEORIA, IL
ZIP 61637
Phone: (309) 655-2109
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DR. Jenna Marie Lizzo, MD, MA is a student in an organized health care education training program in Peoria, IL. The provider is an individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. DR. Jenna Marie Lizzo, MD, MA NPI is 1972009124. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

530 NE GLEN OAK AVE
PEORIA, IL
ZIP 61637-001
Phone: (309) 655-2109

The NPI 1972009124 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 4/4/2018 and was last updated on 1/1/2021.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207LC0200XAnesthesiologyCritical Care MedicineMD-48039IOWANo
2390200000XStudent in an Organized Health Care Education/Training ProgramYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.