MEDICARE: ZICHI-PHILLIPS ENTERPRISES, 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	273Y00000X	Rehabilitation Hospital Unit	234521	MI

General Provider Information

NPI Number	:	1427056514
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ZICHI-PHILLIPS ENTERPRISES, LLC

Provider Business Mailing Address
First Line	:	18600 VAN HORN RD
Second Line	:
City	:	WOODHAVEN
State	:	MI
Zip	:	48183-3828
Country	:	US
Telephone Number	:	734-675-0300
Fax Number	:

Provider Business Practice Location Address
First Line	:	18600 VAN HORN RD
Second Line	:
City	:	WOODHAVEN
State	:	MI
Zip	:	48183-3828
Country	:	US
Telephone Number	:	734-675-0300
Fax Number	:

Authorized Official
Title or Position	:	OWNER/ADMINISTRATOR
Name	:	DR. ABDUL CHOUDRY
Credential	:
Telephone Number	:	734-675-0300

Provider Enumeration Date	:	07/12/2005
Last Update Date	:	01/25/2008

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