1497958201 NPI number — DR. MEIRAJ F ZUBERI MD

Table of content: DR. MEIRAJ F ZUBERI MD (NPI 1497958201)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1497958201 NPI number — DR. MEIRAJ F ZUBERI MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ZUBERI
Provider First Name:
MEIRAJ
Provider Middle Name:
F
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
F

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:
1497958201
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
09/02/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1367 N DIVISION ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MORRIS
Provider Business Mailing Address State Name:
IL
Provider Business Mailing Address Postal Code:
60450-1431
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
815-680-6806
Provider Business Mailing Address Fax Number:
815-729-3399

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1367 N DIVISION ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MORRIS
Provider Business Practice Location Address State Name:
IL
Provider Business Practice Location Address Postal Code:
60450-1444
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
815-941-2007
Provider Business Practice Location Address Fax Number:
815-941-2132
Provider Enumeration Date:
06/08/2007

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: 207RE0101X , with the licence number:  036-112234 , registered in the state of IL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 036112234-2 , issued by the state of ( IL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 808070 . This is a "MEDICARE" identifier , issued by the state of ( IL ) . This identifiers is of the category "OTHER".




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