Healthcare Provider Details

I. General information

NPI: 1669224085
Provider Name (Legal Business Name): ZAYNA SHAQILDI DPM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/02/2024
Last Update Date: 08/04/2026
Certification Date: 08/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4440 W 95TH ST
OAK LAWN IL
60453-2600
US

IV. Provider business mailing address

10338 S 82ND CT
PALOS HILLS IL
60465-1843
US

V. Phone/Fax

Practice location:
  • Phone: 708-684-5682
  • Fax: 708-684-3142
Mailing address:
  • Phone: 708-378-8154
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number1669224085
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: