Healthcare Provider Details

I. General information

NPI: 1104473263
Provider Name (Legal Business Name): MOTIVATED MEDICINE, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/23/2019
Last Update Date: 11/15/2022
Certification Date: 12/16/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

480 E ROOSEVELT RD STE 105
WEST CHICAGO IL
60185-3969
US

IV. Provider business mailing address

480 E ROOSEVELT RD STE 105
WEST CHICAGO IL
60185-3969
US

V. Phone/Fax

Practice location:
  • Phone: 630-492-1965
  • Fax: 630-492-0933
Mailing address:
  • Phone: 630-492-1965
  • Fax: 630-492-0933

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: DR. SARAH JOY ZIELSDORF
Title or Position: DIRECT OWNER
Credential: M.D.
Phone: 630-492-1965