Healthcare Provider Details

I. General information

NPI: 1295927440
Provider Name (Legal Business Name): ZAKIA K SIAL M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/13/2007
Last Update Date: 08/27/2026
Certification Date: 08/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25412 GODDARD RD
TAYLOR MI
48180-6200
US

IV. Provider business mailing address

3601 W TEDFORD DR
PEORIA IL
61614-1034
US

V. Phone/Fax

Practice location:
  • Phone: 313-985-0900
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number4301090903
License Number StateMI
# 2
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number4301090903
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: