Healthcare Provider Details

I. General information

NPI: 1316058209
Provider Name (Legal Business Name): MEHRUNNISA A ZARIF M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/31/2006
Last Update Date: 01/04/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1S161 SUMMIT AVE
OAKBROOK TERRACE IL
60181-3904
US

IV. Provider business mailing address

3525 CASS CT SUITE # 410
OAK BROOK IL
60523-2633
US

V. Phone/Fax

Practice location:
  • Phone: 630-620-6666
  • Fax: 847-843-7479
Mailing address:
  • Phone: 630-620-6666
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number036044846
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: