1629079769 NPI number — DR. ZEESHAN SHAHRIAR HUSAIN DPM

Table of content: DR. ZEESHAN SHAHRIAR HUSAIN DPM (NPI 1629079769)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1629079769 NPI number — DR. ZEESHAN SHAHRIAR HUSAIN DPM

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HUSAIN
Provider First Name:
ZEESHAN
Provider Middle Name:
SHAHRIAR
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
DPM
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1629079769
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
05/18/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
9400 S CICERO AVE STE 100
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
OAK LAWN
Provider Business Mailing Address State Name:
IL
Provider Business Mailing Address Postal Code:
60453-2536
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
708-424-3201
Provider Business Mailing Address Fax Number:
708-424-5001

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1135 W UNIVERSITY DR STE 305
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ROCHESTER
Provider Business Practice Location Address State Name:
MI
Provider Business Practice Location Address Postal Code:
48307-1892
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
586-725-3444
Provider Business Practice Location Address Fax Number:
586-725-0984
Provider Enumeration Date:
08/10/2005

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 213ES0103X , with the licence number:  5901002007 , registered in the state of MI ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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