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General NPI Number Information
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NPI Number | 1487817524
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Entity Type | Individual
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Provider Name | ZACHARY LOVE M.D.
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Gender | Male
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Dates
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Enumeration Date | 07/09/2008
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Last Update Date | 02/22/2024
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Provider Practice Location Address
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Address Line | 1901 W HARRISON ST DEPT OF RADIOLOGY, RM. 2533
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City | CHICAGO
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State | IL
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Zip | 60612-3714
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Country | US
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Telephone | 312-864-3826
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Fax |
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Provider Business Mailing Address
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Address Line | 2310 S CANAL ST UNIT 514
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City | CHICAGO
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State | IL
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Zip | 60616-2017
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Country | US
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Telephone | 503-752-1795
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | MD-19980
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License Number State | HI
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Taxonomy #2
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Taxonomy Code | 2085R0204X
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Taxonomy Name | Vascular & Interventional Radiology Physician
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License Number | 036.132842
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License Number State | IL
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