MEDICARE: ROBERT J ZOMBOLO DPM

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	213E00000X	Podiatrist	016004703	IL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1528015435
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROBERT J ZOMBOLO DPM

Provider Business Mailing Address
First Line	:	2180 PFINGSTEN RD STE 3100
Second Line	:
City	:	GLENVIEW
State	:	IL
Zip	:	60026-1339
Country	:	US
Telephone Number	:	847-866-7846
Fax Number	:	866-940-9890

Provider Business Practice Location Address
First Line	:	2180 PFINGSTEN RD STE 3100
Second Line	:
City	:	GLENVIEW
State	:	IL
Zip	:	60026-1339
Country	:	US
Telephone Number	:	847-866-7846
Fax Number	:	866-940-9890

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

Provider Enumeration Date	:	05/27/2006
Last Update Date	:	10/13/2020

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