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NPI Code Detail

MEDICARE: RALPH PIERCE ZEHLER III PA-C

MEDICARE:   RALPH PIERCE ZEHLER III PA-C
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
1363A00000XPhysician Assistant085006771IL
2363AS0400XSurgical Physician AssistantPA10001576WA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
10196113OTHERWAL&I AND CRIME VICTIMS
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1972562643
Entity Type Code : Individual
Provider Name (Legal Business Name) : RALPH PIERCE ZEHLER III PA-C
Provider Business Mailing Address
First Line : 4309 W MEDICAL CENTER DR STE A200
Second Line :
City : MCHENRY
State : IL
Zip : 60050-8437
Country : US
Telephone Number : 815-759-8070
Fax Number : 815-759-4931
Provider Business Practice Location Address
First Line : 4309 W MEDICAL CENTER DR STE A200
Second Line :
City : MCHENRY
State : IL
Zip : 60050-8437
Country : US
Telephone Number : 815-759-8070
Fax Number : 815-759-4931
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/21/2006
Last Update Date : 01/30/2023

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1922003193 — AQEEL A SANDHU M.D.
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1912984402 — MARGARET R SOFORENKO APRN, CNP
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Practice Fax: 815-759-4931

Directions to “ RALPH PIERCE ZEHLER III PA-C” Practice Location

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