Healthcare Provider Details

I. General information

NPI: 1811394158
Provider Name (Legal Business Name): ZAYAN LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/02/2014
Last Update Date: 05/03/2023
Certification Date: 05/03/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1420 RENAISSANCE DR STE 211
PARK RIDGE IL
60068-1342
US

IV. Provider business mailing address

1420 RENAISSANCE DR STE 211
PARK RIDGE IL
60068-1342
US

V. Phone/Fax

Practice location:
  • Phone: 847-380-7644
  • Fax: 844-549-2273
Mailing address:
  • Phone: 847-380-7644
  • Fax: 844-549-2273

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code376J00000X
TaxonomyHomemaker
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number3001142
License Number StateIL

VIII. Authorized Official

Name: SHAFIA A KHATOON
Title or Position: PRESIDENT
Credential: RDH
Phone: 847-380-7644