Dr. Martin J Zidron
Oral and Maxillofacial Pathology
21660 W Field Pkwy Suite 220
Deer Park
, Illinois 60010-7265
Dr. Martin J Zidron
Oral and Maxillofacial Pathology
21660 W Field Pkwy Suite 220
Deer Park
, Illinois 60010-7265
(847) 381-0265
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About
Features
Specialties
- Oral and Maxillofacial Pathology
Languages spoken
- English
Location
First Address
- Dr. Martin J Zidron
- 21660 W Field Pkwy Suite 220
- Deer Park, IL
- Zip : 60010-7265
- Fax : (847) 381-0265
- Phone : (847) 381-0106
Second Address
- Dr. Martin J Zidron
- 21660 W Field Pkwy Suite 220
- Deer Park, IL
- Zip : 60010-7265
- Fax : (847) 381-0265
- Phone : (847) 381-0106
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 1223P0106X | Oral and Maxillofacial Pathology | 019-017572 | IL |
National Provider Identifier
| NPI | 1164462362 |
|---|---|
| Provider Name | Dr. Martin J Zidron |
| First Address | Deer Park, IL 60010-7265 |
| Second Address | Deer Park, IL 60010-7265 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 07/06/2006 |
| Last Update Date | 24/07/2012 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 80002564 | BCBS PROVIDER NUMBER (01) | IL |
| 80022564 | BCBS PROVIDER NUMBER (01) | IL |
| T87155 | (02) | IL |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.