Healthcare Provider Details
I. General information
NPI: 1114277688
Provider Name (Legal Business Name): RACHEL ZORGER DPM
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 09/12/2012
Last Update Date: 08/11/2023
Certification Date: 12/20/2021
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2220 W BELMONT AVE
CHICAGO IL
60618-6421
US
IV. Provider business mailing address
225 S JEFFERSON ST
CHICAGO IL
60661-5607
US
V. Phone/Fax
- Phone: 773-348-7500
- Fax: 773-348-7500
- Phone: 312-612-5000
- Fax: 312-612-5000
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 213E00000X |
| Taxonomy | Podiatrist |
| License Number | LPR00116 |
| License Number State | RI |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 213E00000X |
| Taxonomy | Podiatrist |
| License Number | 016005760 |
| License Number State | IL |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: