Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | MDR5973 | HI |
Y | 2080P0202X | Pediatric Cardiologist | 036132736 | IL |
NPI | 1255646675 |
---|---|
Provider Name | Dr. Syed Javed Hasan Zaidi |
First Address | Normal, IL 61761-6523 |
Second Address | Normal, IL 61761 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/08/2010 |
Last Update Date | 24/04/2020 |