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General NPI Number Information
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NPI Number | 1578235883
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Entity Type | Organization
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Legal Business Name | PINNACLE GASTROENTEROLOGY SC
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Dates
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Enumeration Date | 10/05/2021
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Last Update Date | 08/26/2022
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Provider Practice Location Address
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Address Line | 3 N MAIN ST
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City | MANTENO
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State | IL
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Zip | 60950-1534
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Country | US
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Telephone | 833-368-8688
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Fax | 779-216-5333
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Provider Business Mailing Address
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Address Line | 1323 S FEDERAL ST
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City | CHICAGO
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State | IL
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Zip | 60605-2716
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Country | US
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Telephone | 312-218-8889
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Fax |
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Authorized Official
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Title or Position | CO-PRESIDENT
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Name | DR. ZAHID AFZAL
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Credential | M.D.
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Telephone | 630-804-9555
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number |
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License Number State |
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