Healthcare Provider Details

I. General information

NPI: 1396765160
Provider Name (Legal Business Name): ANGELA E ZARATE M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ANGELA E NANTO M.D.

II. Dates (important events)

Enumeration Date: 07/21/2006
Last Update Date: 01/12/2022
Certification Date: 01/12/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2300 N CHILDRENS PLZ
CHICAGO IL
60614-3363
US

IV. Provider business mailing address

2300 N CHILDRENS PLZ BOX 152
CHICAGO IL
60614-3363
US

V. Phone/Fax

Practice location:
  • Phone: 773-880-6903
  • Fax: 773-880-3068
Mailing address:
  • Phone: 773-880-6903
  • Fax: 773-880-3068

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number036-116472
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: