Healthcare Provider Details

I. General information

NPI: 1790006393
Provider Name (Legal Business Name): SYED ZAHID AZIZ KHALID D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: ZAHID AZIZ KHALID D.O.

II. Dates (important events)

Enumeration Date: 06/17/2010
Last Update Date: 03/06/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2361 PAYSPHERE CIRCLE
CHICAGO IL
60674
US

IV. Provider business mailing address

2520 ELISHA AVENUE
ZION IL
60099
US

V. Phone/Fax

Practice location:
  • Phone: 847-746-4358
  • Fax:
Mailing address:
  • Phone: 847-872-6259
  • Fax: 847-872-5716

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 Code207P00000X
TaxonomyEmergency Medicine Physician
License Number036.131684
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: