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General NPI Number Information
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NPI Number | 1043459985
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Entity Type | Organization
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Legal Business Name | UNIVERSITY FOOT SPECIALISTS LTD
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Dates
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Enumeration Date | 02/17/2009
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Last Update Date | 12/07/2009
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Provider Practice Location Address
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Address Line | 552 S WASHINGTON ST SUITE 116
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City | NAPERVILLE
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State | IL
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Zip | 60540-6658
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Country | US
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Telephone | 630-983-5694
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Fax | 630-983-5632
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Provider Business Mailing Address
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Address Line | 552 S WASHINGTON ST SUITE 116
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City | NAPERVILLE
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State | IL
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Zip | 60540-6658
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Country | US
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Telephone | 630-983-5694
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Fax | 630-983-5632
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Authorized Official
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Title or Position | OWNER/PHYSICIAN
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Name | KENNETH H ZYGMUNT
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Credential | DPM
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Telephone | 630-983-5694
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number | 016003250
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License Number State | IL
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