Healthcare Provider Details

I. General information

NPI: 1265119226
Provider Name (Legal Business Name): ZAP BEAUTY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/30/2023
Last Update Date: 09/22/2023
Certification Date: 09/22/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

629 W STATE ST
GENEVA IL
60134-2159
US

IV. Provider business mailing address

629 W STATE ST
GENEVA IL
60134-2159
US

V. Phone/Fax

Practice location:
  • Phone: 630-491-4927
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code246Z00000X
TaxonomyOther Specialist/Technologist
License Number
License Number State

VIII. Authorized Official

Name: MAHRUN ZECEVIC
Title or Position: PRESIDENT
Credential:
Phone: 630-491-4927