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General NPI Number Information
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NPI Number | 1508616889
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Entity Type | Organization
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Legal Business Name | ZAKENN MEDICAL CENTER LLC
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Dates
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Enumeration Date | 03/27/2024
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Last Update Date | 03/27/2024
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Provider Practice Location Address
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Address Line | 5732 W NORTH AVE
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City | CHICAGO
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State | IL
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Zip | 60639-4152
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Country | US
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Telephone | 312-292-1986
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Fax |
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Provider Business Mailing Address
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Address Line | 240 WALTHAM ST
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City | CALUMET CITY
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State | IL
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Zip | 60409-5234
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Country | US
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Telephone | 312-292-1986
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Fax |
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Authorized Official
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Title or Position | APRN
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Name | NNEKA OKAGBUE
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Credential | APRN
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Telephone | 312-292-1986
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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