MEDICARE: ANDERSON MEDICAL CENTERS, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician

General Provider Information

NPI Number	:	1326231432
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ANDERSON MEDICAL CENTERS, LLC

Provider Business Mailing Address
First Line	:	609 ACADEMY DR
Second Line	:
City	:	NORTHBROOK
State	:	IL
Zip	:	60062-2420
Country	:	US
Telephone Number	:	847-223-9494
Fax Number	:	847-205-9722

Provider Business Practice Location Address
First Line	:	661 GRACELAND AVE
Second Line	:
City	:	DES PLAINES
State	:	IL
Zip	:	60016-4518
Country	:	US
Telephone Number	:	847-223-9494
Fax Number	:	847-205-9722

Authorized Official
Title or Position	:	MANAGING DIRECTOR
Name	:	DR. MAYER ZAYAN
Credential	:	MD
Telephone Number	:	847-223-9494

Provider Enumeration Date	:	08/22/2007
Last Update Date	:	08/22/2007

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