Healthcare Provider Details

I. General information

NPI: 1437611761
Provider Name (Legal Business Name): ZAID IFTEKARUDDIN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/04/2019
Last Update Date: 05/22/2026
Certification Date: 05/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4405 WEAVER PKWY
WARRENVILLE IL
60555-3269
US

IV. Provider business mailing address

161 E CHICAGO AVE UNIT 52B
CHICAGO IL
60611-6684
US

V. Phone/Fax

Practice location:
  • Phone: 630-933-7811
  • Fax: 630-352-5349
Mailing address:
  • Phone: 312-864-3838
  • Fax: 312-864-9295

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number125.073608
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code2085R0001X
TaxonomyRadiation Oncology Physician
License Number036.170440
License Number StateIL
# 3
Primary TaxonomyN
Taxonomy Code2085R0001X
TaxonomyRadiation Oncology Physician
License Number125.073608
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: