Izydor, Ted D

Izydor, Ted D is an individual health care provider with primary practice located at 128 E Olin Ave Suite 100, Madison WI 53713-1467. He recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), Behavioral Health & Social Service Providers / Professional. Behavioral Health & Social Service Providers / Professional is his primary health care specialty. Izydor, Ted D can be contacted via phone (608) 252-1320.

Contact Information

Primary practice address
128 E Olin Ave Suite 100 Madison WI 53713-1467
Phone: (608) 252-1320
Fax: (608) 252-1333
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X 14034-132 Wisconsin
Behavioral Health & Social Service Providers / Professional 101YP2500X 2878 Wisconsin

Profile Details

NPI number 1275501140
LBN Legal business name Izydor, Ted D
Credentials Licensed Professional Counselor (LPC)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 8th, 2006
Last updated Oct 21st, 2011 - about 15 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1275501140 NPPES
Wisconsin MEDICAID 1275501140

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