MEDICARE: DR. HEE CHONG JENNIFER ZIMMERMAN MD

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	207Q00000X	Family Medicine Physician	036.165856	IL
2	207Q00000X	Family Medicine Physician	DR.0073448	CO

General Provider Information

NPI Number	:	1609405653
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. HEE CHONG JENNIFER ZIMMERMAN MD

Provider Business Mailing Address
First Line	:	PO BOX 746721
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30374-6721
Country	:	US
Telephone Number	:	312-733-9730
Fax Number	:	773-866-8014

Provider Business Practice Location Address
First Line	:	1450 DEXTER ST # 102
Second Line	:
City	:	FORT LUPTON
State	:	CO
Zip	:	80621-1503
Country	:	US
Telephone Number	:	303-857-7873
Fax Number	:	303-857-7926

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

Provider Enumeration Date	:	04/02/2020
Last Update Date	:	02/19/2025

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