Healthcare Provider Details

I. General information

NPI: 1093463531
Provider Name (Legal Business Name): EMILY ZIGNEGO MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: EMILY WUSTERBARTH MD

II. Dates (important events)

Enumeration Date: 03/14/2022
Last Update Date: 04/02/2026
Certification Date: 04/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1775 DEMPSTER ST
PARK RIDGE IL
60068-1143
US

IV. Provider business mailing address

1775 DEMPSTER ST
PARK RIDGE IL
60068-1143
US

V. Phone/Fax

Practice location:
  • Phone: 847-723-2210
  • Fax:
Mailing address:
  • Phone: 847-723-2210
  • Fax: 847-723-6987

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License Number125.081770
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number125081770
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: