Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RA0201X | Internist - Allergy & Immunology | IL |
NPI | 1154432532 |
---|---|
Provider Name | Chester R Zeiss |
First Address | Evanston, IL 60201-1519 |
Second Address | Chicago, IL 60611-3004 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 31/08/2006 |
Last Update Date | 08/07/2007 |