MEDICARE: DEREK ZID D.C., CNIM

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	111N00000X	Chiropractor	038-008863	IL
2	246ZE0600X	Electroneurodiagnostic Specialist/Technologist

General Provider Information

NPI Number	:	1447235544
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DEREK ZID D.C., CNIM

Provider Business Mailing Address
First Line	:	1440 W NORTH AVE
Second Line	:	SUITE 307
City	:	MELROSE PARK
State	:	IL
Zip	:	60160-1422
Country	:	US
Telephone Number	:	708-345-1299
Fax Number	:

Provider Business Practice Location Address
First Line	:	1440 W NORTH AVE
Second Line	:	SUITE 307
City	:	MELROSE PARK
State	:	IL
Zip	:	60160-1422
Country	:	US
Telephone Number	:	708-345-1299
Fax Number	:

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

Provider Enumeration Date	:	12/12/2005
Last Update Date	:	05/22/2023

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