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NPI Code Detail

MEDICARE: RANDY RAY ZIMMERMAN MD

MEDICARE:   RANDY RAY ZIMMERMAN  MD
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
1207V00000XObstetrics & Gynecology PhysicianIL
2207V00000XObstetrics & Gynecology PhysicianIL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
14921797OTHERILBCBS

General Provider Information

NPI Number : 1427044171
Entity Type Code : Individual
Provider Name (Legal Business Name) : RANDY RAY ZIMMERMAN MD
Provider Business Mailing Address
First Line : 27750 W HIGHWAY 22
Second Line : STE 120
City : BARRINGTON
State : IL
Zip : 60010-2379
Country : US
Telephone Number : 847-277-0500
Fax Number : 847-277-0505
Provider Business Practice Location Address
First Line : 27750 W HIGHWAY 22
Second Line : STE 120
City : BARRINGTON
State : IL
Zip : 60010-2379
Country : US
Telephone Number : 847-277-0500
Fax Number : 847-277-0505
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/27/2005
Last Update Date : 11/26/2007

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Directions to “ RANDY RAY ZIMMERMAN MD” Practice Location

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