Healthcare Provider Details

I. General information

NPI: 1720047012
Provider Name (Legal Business Name): DIANE MARIE ZARY D.C.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/23/2006
Last Update Date: 10/23/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

82 63RD ST
WILLOW BROOK IL
60527-2982
US

IV. Provider business mailing address

231 S GRANT ST
WESTMONT IL
60559-1909
US

V. Phone/Fax

Practice location:
  • Phone: 630-455-5640
  • Fax:
Mailing address:
  • Phone: 630-455-5640
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number038-008043
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: