Healthcare Provider Details

I. General information

NPI: 1144959412
Provider Name (Legal Business Name): CHENYI ZHENG
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/09/2022
Last Update Date: 07/08/2024
Certification Date: 07/08/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1309 S HALSTED ST
CHICAGO IL
60607-5003
US

IV. Provider business mailing address

1740 W TAYLOR ST
CHICAGO IL
60612-7232
US

V. Phone/Fax

Practice location:
  • Phone: 312-413-3000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License Number209.025647
License Number StateIL
# 3
Primary TaxonomyN
Taxonomy Code176B00000X
TaxonomyMidwife
License Number209025647
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: