Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208200000X | Surgeon | PGY202791 | LA |
N | 208600000X | Surgeon | PGY202791 | LA |
Y | 2086S0129X | Vascular Surgeon | 036.151188 | IL |
NPI | 1083009948 |
---|---|
Provider Name | Dr. Mary Kala Zorn |
First Address | Maywood, IL 60153-3328 |
Second Address | Maywood, IL 60153-3328 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 30/03/2015 |
Last Update Date | 30/05/2020 |