Healthcare Provider Details

I. General information

NPI: 1003901067
Provider Name (Legal Business Name): ZUCKER & ZUCKER PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/04/2006
Last Update Date: 04/01/2025
Certification Date: 04/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

244 ARROWWOOD DR
NORTHBROOK IL
60062-1039
US

IV. Provider business mailing address

244 ARROWWOOD DR
NORTHBROOK IL
60062-1039
US

V. Phone/Fax

Practice location:
  • Phone: 847-509-1320
  • Fax: 847-509-1320
Mailing address:
  • Phone: 847-778-0573
  • Fax: 708-452-4593

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License Number
License Number State

VIII. Authorized Official

Name: KEVIN BRUCE ZUCKER
Title or Position: PRESIDENT
Credential:
Phone: 847-778-0573