Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207P00000X | Emergency Physician | 036-104026 | IL |
Y | 207R00000X | Internist | 036104026 | IL |
Y | 111NI0900X | Internist | 036104026 | IL |
NPI | 1013022565 |
---|---|
Provider Name | David Zich |
First Address | Chicago, IL 60604-2402 |
Second Address | Chicago, IL 60604-2402 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/08/2006 |
Last Update Date | 17/04/2013 |