Healthcare Provider Details

I. General information

NPI: 1063852895
Provider Name (Legal Business Name): AMAZEHEALTH WEIGHT LOSS & WELLNESS, SC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/25/2013
Last Update Date: 06/25/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2340 S HIGHLAND AVE SUITE 370
LOMBARD IL
60148-5371
US

IV. Provider business mailing address

2340 S HIGHLAND AVE SUITE 370
LOMBARD IL
60148-5371
US

V. Phone/Fax

Practice location:
  • Phone: 630-873-5245
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207QB0002X
TaxonomyObesity Medicine (Family Medicine) Physician
License Number036099120
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number036099120
License Number StateIL

VIII. Authorized Official

Name: DR. SYED ZAFFER
Title or Position: PRESIDENT
Credential: M.D.
Phone: 630-873-5425