Healthcare Provider Details

I. General information

NPI: 1942255377
Provider Name (Legal Business Name): AMJAD A ZUREIKAT MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: AMJAD A ZUREIKAT MD

II. Dates (important events)

Enumeration Date: 05/24/2006
Last Update Date: 03/07/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4754 N LINCOLN AVE
CHICAGO IL
60625-2010
US

IV. Provider business mailing address

4754 N LINCOLN AVE SUITE 2
CHICAGO IL
60625-2010
US

V. Phone/Fax

Practice location:
  • Phone: 773-878-4000
  • Fax: 773-283-4177
Mailing address:
  • Phone: 773-878-4000
  • Fax: 773-283-4177

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number036061660
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: