Healthcare Provider Details

I. General information

NPI: 1063074011
Provider Name (Legal Business Name): ZEBI FATIMA MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/30/2019
Last Update Date: 12/11/2025
Certification Date: 12/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10400 75TH ST
KENOSHA WI
53142-7884
US

IV. Provider business mailing address

29624 NETWORK PL
CHICAGO IL
60673-1296
US

V. Phone/Fax

Practice location:
  • Phone: 262-942-5600
  • Fax:
Mailing address:
  • Phone: 608-741-7652
  • Fax: 815-337-4793

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number73925
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: