MEDICARE: HEALTH ZONE, LLC

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	251K00000X	Public Health or Welfare Agency

General Provider Information

NPI Number	:	1720425119
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HEALTH ZONE, LLC

Provider Business Mailing Address
First Line	:	3647 W LAWRENCE AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60625-5625
Country	:	US
Telephone Number	:	773-747-8455
Fax Number	:

Provider Business Practice Location Address
First Line	:	3647 W LAWRENCE AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60625-5625
Country	:	US
Telephone Number	:	773-747-8455
Fax Number	:

Authorized Official
Title or Position	:	MANAGER
Name	:	MR. KARIM RAJANI
Credential	:
Telephone Number	:	773-747-8455

Provider Enumeration Date	:	05/27/2013
Last Update Date	:	05/27/2013

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