MEDICARE: NASSER ZAKIEH M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RC0200X	Critical Care Medicine (Internal Medicine) Physician	036104388	IL
2	207RP1001X	Pulmonary Disease Physician	036104388	IL

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
3	290014983	OTHER	IL	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	01632457	OTHER	IL	BLUE CROSS BLUE SHIELD
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1245294818
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NASSER ZAKIEH M.D.

Provider Business Mailing Address
First Line	:	10604 SOUTHWEST HIGHWAY
Second Line	:	STE 107
City	:	CHICAGO RIDGE
State	:	IL
Zip	:	60415-2717
Country	:	US
Telephone Number	:	708-422-0636
Fax Number	:	708-424-2164

Provider Business Practice Location Address
First Line	:	10604 SOUTHWEST HIGHWAY
Second Line	:	STE 107
City	:	CHICAGO RIDGE
State	:	IL
Zip	:	60415-2717
Country	:	US
Telephone Number	:	708-422-0636
Fax Number	:	708-424-2164

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/12/2006
Last Update Date	:	06/07/2018

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Directions to “ NASSER ZAKIEH M.D.” Practice Location

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