Healthcare Provider Details

I. General information

NPI: 1275461550
Provider Name (Legal Business Name): ZIVORA HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/08/2026
Last Update Date: 05/08/2026
Certification Date: 05/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

474 N LAKE SHORE DR
CHICAGO IL
60611-3400
US

IV. Provider business mailing address

474 N LAKE SHORE DR
CHICAGO IL
60611-3400
US

V. Phone/Fax

Practice location:
  • Phone: 312-694-5487
  • Fax: 240-368-1235
Mailing address:
  • Phone: 312-694-5487
  • Fax: 240-368-1235

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: ELIZABETH KUKOYI
Title or Position: SOLE PROPERITOR
Credential:
Phone: 312-694-5487