Healthcare Provider Details

I. General information

NPI: 1689616625
Provider Name (Legal Business Name): FRANK ZAKER O.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/12/2006
Last Update Date: 09/17/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9602 S ROBERTS RD
HICKORY HILLS IL
60457-2238
US

IV. Provider business mailing address

22435 CRIMSON LN
FRANKFORT IL
60423-8554
US

V. Phone/Fax

Practice location:
  • Phone: 708-237-2020
  • Fax: 708-237-2210
Mailing address:
  • Phone: 815-806-8371
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number046008268
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: