Healthcare Provider Details

I. General information

NPI: 1326046681
Provider Name (Legal Business Name): OLGA ZUK M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/11/2005
Last Update Date: 05/24/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5140 N CALIFORNIA AVE SUITE 115
CHICAGO IL
60625-3645
US

IV. Provider business mailing address

6923 W SHAKESPEARE AVE #2
CHICAGO IL
60707-3355
US

V. Phone/Fax

Practice location:
  • Phone: 773-989-3803
  • Fax: 773-878-5726
Mailing address:
  • Phone: 773-385-6529
  • Fax: 773-385-6673

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License Number036070498
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: