MEDICARE: ZAID IM HADDAD M.D.

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	207RN0300X	Nephrology Physician	19224	NV
2	207RN0300X	Nephrology Physician	A141772	CA
3	207R00000X	Internal Medicine Physician	125.063562	IL
4	207RN0300X	Nephrology Physician	036160661	IL

General Provider Information

NPI Number	:	1538509971
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ZAID IM HADDAD M.D.

Provider Business Mailing Address
First Line	:	210 S DESPLAINES ST FL 1
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60661-5544
Country	:	US
Telephone Number	:	312-654-2720
Fax Number	:	312-654-0118

Provider Business Practice Location Address
First Line	:	6959 S PULASKI RD
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60629-4238
Country	:	US
Telephone Number	:	312-654-2720
Fax Number	:

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

Provider Enumeration Date	:	06/30/2013
Last Update Date	:	09/30/2025

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