IndividualActive
Jennifer Defazio, M.D.
NPI 1235441429 · Pediatric Surgery Physician · Chicago, IL
Provider details
- NPI number
- 1235441429
- Entity type
- Individual
- Primary specialty
- Pediatric Surgery PhysicianAllopathic & Osteopathic Physicians
- Credential
- M.D.
- Sex
- Female
- Sole proprietor
- Yes
- License
- 288868-1 (NY)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Practice location
5841 S Maryland Ave
Chicago, IL 60637-1447
Phone: (773) 702-1000
Approximate (ZIP-level) locationGet directions
Mailing address
3959 Broadway Rm 216b
New York, NY 10032-1559
Registry dates
- Enumerated
- 2010-07-05
- Last updated
- 2020-01-23
- Certified
- 2020-01-23
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.