Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 213ES0103X | Foot & Ankle Surgery | 135000849 | IL |
Y | 213ES0103X | Foot & Ankle Surgery | 2017010428 | MO |
NPI | 1073928164 |
---|---|
Provider Name | Zachary Alexander Zobens |
First Address | Chicago, IL 60622-1908 |
Second Address | Saint Louis, MO 63125-3260 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/06/2014 |
Last Update Date | 13/04/2017 |