Healthcare Provider Details

I. General information

NPI: 1922742428
Provider Name (Legal Business Name): GANG ZHOU MD, PHD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/21/2022
Last Update Date: 08/08/2026
Certification Date: 08/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

676 N SAINT CLAIR ST STE 850
CHICAGO IL
60611-3124
US

IV. Provider business mailing address

676 N SAINT CLAIR ST STE 850
CHICAGO IL
60611-3124
US

V. Phone/Fax

Practice location:
  • Phone: 312-926-7008
  • Fax: 312-694-1128
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207ZP0102X
TaxonomyAnatomic Pathology & Clinical Pathology Physician
License Number036173184
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: