Healthcare Provider Details

I. General information

NPI: 1215341425
Provider Name (Legal Business Name): DAWEN ZHANG M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/16/2014
Last Update Date: 08/11/2022
Certification Date: 08/11/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1220 HOBSON RD STE 104
NAPERVILLE IL
60540-8137
US

IV. Provider business mailing address

1220 HOBSON RD STE 104
NAPERVILLE IL
60540-8137
US

V. Phone/Fax

Practice location:
  • Phone: 630-961-2810
  • Fax: 630-961-2658
Mailing address:
  • Phone: 630-961-2810
  • Fax: 630-961-2658

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number125065309
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code207RR0500X
TaxonomyRheumatology Physician
License Number036.149491
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: