Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213E00000X | Podiatrist | 016005011 | IL |
Y | 222Z00000X | Podiatrist | 016005011 | IL |
NPI | 1013094432 |
---|---|
Provider Name | Dr. Marwan Zayed |
First Address | Downers Grove, IL 60515-2829 |
Second Address | Chicago, IL 60634-2237 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/11/2006 |
Last Update Date | 22/08/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
U87413 | (02) |