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General NPI Number Information
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NPI Number | 1720660897
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Entity Type | Individual
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Provider Name | JAAFAR ZALZALEH DO
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Gender | Male
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Dates
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Enumeration Date | 04/27/2021
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Last Update Date | 08/07/2025
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Provider Practice Location Address
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Address Line | 6345 W 79TH ST
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City | BURBANK
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State | IL
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Zip | 60459-1133
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Country | US
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Telephone | 844-725-5238
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Fax | 708-346-8285
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Provider Business Mailing Address
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Address Line | 29373 NETWORK PL
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City | CHICAGO
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State | IL
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Zip | 60673-1293
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Country | US
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Telephone | 847-390-5900
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Fax | 847-390-4757
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 5151014845
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 207QH0002X
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Taxonomy Name | Hospice and Palliative Medicine (Family Medicine) Physician
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License Number | 81464-21
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License Number State | WI
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Taxonomy #3
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Taxonomy Code | 207QH0002X
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Taxonomy Name | Hospice and Palliative Medicine (Family Medicine) Physician
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License Number | 036.175815
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License Number State | IL
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