Healthcare Provider Details

I. General information

NPI: 1942269634
Provider Name (Legal Business Name): ZEHAVA LELA NOAH MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/21/2006
Last Update Date: 12/26/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

225 E CHICAGO AVE BOX 73
CHICAGO IL
60611-2991
US

IV. Provider business mailing address

225 E CHICAGO AVE BOX 73
CHICAGO IL
60611-2991
US

V. Phone/Fax

Practice location:
  • Phone: 312-227-4800
  • Fax: 312-227-9753
Mailing address:
  • Phone: 312-227-4800
  • Fax: 312-227-9753

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080P0203X
TaxonomyPediatric Critical Care Medicine Physician
License Number036051735
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: