Healthcare Provider Details

I. General information

NPI: 1063784452
Provider Name (Legal Business Name): ZIBUTE G ZAPARACKAS MD AND PAUL A KNEPPER MD LTD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/01/2012
Last Update Date: 04/13/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

150 E HURON ST SUITE 1000
CHICAGO IL
60611-2999
US

IV. Provider business mailing address

150 E HURON ST SUITE 1000
CHICAGO IL
60611-2999
US

V. Phone/Fax

Practice location:
  • Phone: 312-337-1285
  • Fax:
Mailing address:
  • Phone: 312-337-1285
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number036045972
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number036043045
License Number StateIL

VIII. Authorized Official

Name: PAUL A KNEPPER
Title or Position: TREASURER
Credential: M.D., PH.D.
Phone: 312-337-1285