Healthcare Provider Details

I. General information

NPI: 1548983877
Provider Name (Legal Business Name): AZ CHIROPRACTIC PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/21/2022
Last Update Date: 12/19/2022
Certification Date: 12/19/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15000 CICERO AVE STE 100
OAK FOREST IL
60452-1480
US

IV. Provider business mailing address

15000 CICERO AVE STE 100
OAK FOREST IL
60452-1480
US

V. Phone/Fax

Practice location:
  • Phone: 708-407-9393
  • Fax:
Mailing address:
  • Phone: 708-840-1600
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State

VIII. Authorized Official

Name: DR. ANTHONY ZANAYED
Title or Position: PRESIDENT
Credential: DC
Phone: 708-840-1600