MEDICARE: HANNAN ZAHID

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	213ES0103X	Foot & Ankle Surgery Podiatrist	016.005978	IL
2	390200000X	Student in an Organized Health Care Education/Training Program

General Provider Information

NPI Number	:	1437611720
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HANNAN ZAHID

Provider Business Mailing Address
First Line	:	6304 PRESTON DRIVE
Second Line	:
City	:	SPRINGFIELD
State	:	IL
Zip	:	62711
Country	:	US
Telephone Number	:	217-416-9906
Fax Number	:

Provider Business Practice Location Address
First Line	:	3322 W WILLOW KNOLLS DR
Second Line	:
City	:	PEORIA
State	:	IL
Zip	:	61614-8148
Country	:	US
Telephone Number	:	309-691-5800
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/04/2019
Last Update Date	:	10/05/2022

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Directions to “ HANNAN ZAHID ” Practice Location

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