Healthcare Provider Details

I. General information

NPI: 1548442940
Provider Name (Legal Business Name): MOSHE ZAMIR, M.D. S.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/28/2007
Last Update Date: 07/09/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12525 REGENCY PKWY, STE F
HUNTLEY IL
60142-6500
US

IV. Provider business mailing address

12525 REGENCY PKWY, STE F
HUNTLEY IL
60142-6500
US

V. Phone/Fax

Practice location:
  • Phone: 847-659-8283
  • Fax: 847-659-8345
Mailing address:
  • Phone: 847-659-8283
  • Fax: 847-659-8345

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code302F00000X
TaxonomyExclusive Provider Organization
License Number036052799
License Number StateIL

VIII. Authorized Official

Name: DR. MOSHE ZAMIR
Title or Position: PRESIDENT
Credential: M.D., S.C.
Phone: 847-659-8283