Healthcare Provider Details

I. General information

NPI: 1063598324
Provider Name (Legal Business Name): GREGORY J ZWEIG MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/30/2006
Last Update Date: 02/25/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1834 WALDEN OFFICE SQ #125 OAMRI OF SCHAUMBURG LLC
SCHAUMBURG IL
60173
US

IV. Provider business mailing address

1126 S 70TH ST SUITE N500
MILWAUKEE WI
53214
US

V. Phone/Fax

Practice location:
  • Phone: 847-397-2300
  • Fax: 847-397-6140
Mailing address:
  • Phone: 414-455-4780
  • Fax: 414-475-2936

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2085N0700X
TaxonomyNeuroradiology Physician
License Number036-073392
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number036073392
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: