Healthcare Provider Details

I. General information

NPI: 1306343595
Provider Name (Legal Business Name): ZAIN ABBAS ASHARY
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/12/2018
Last Update Date: 07/05/2023
Certification Date: 07/05/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1520 W HARRISON ST
CHICAGO IL
60607-3106
US

IV. Provider business mailing address

1520 W HARRISON ST
CHICAGO IL
60607-3106
US

V. Phone/Fax

Practice location:
  • Phone: 312-942-2380
  • Fax:
Mailing address:
  • Phone: 312-942-2380
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number036165181
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: