Provider Demographics
NPI:1255325320
Name:PUZIO-BELL, MICHELLE L (DO)
Entity type:Individual
Prefix:
First Name:MICHELLE
Middle Name:L
Last Name:PUZIO-BELL
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21202 OWENS RD STE 201
Mailing Address - Street 2:
Mailing Address - City:MOKENA
Mailing Address - State:IL
Mailing Address - Zip Code:60448-2001
Mailing Address - Country:US
Mailing Address - Phone:779-334-0020
Mailing Address - Fax:779-334-0021
Practice Address - Street 1:21202 OWENS RD STE 201
Practice Address - Street 2:
Practice Address - City:MOKENA
Practice Address - State:IL
Practice Address - Zip Code:60448-2001
Practice Address - Country:US
Practice Address - Phone:779-334-0020
Practice Address - Fax:779-334-0021
Is Sole Proprietor?:No
Enumeration Date:2005-09-06
Last Update Date:2021-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI49241207R00000X
IL036147450207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WIK400238769Medicare PIN