Provider Demographics
NPI:1093375347
Name:HUSSAINI, ZENAT (DPM)
Entity Type:Individual
Prefix:
First Name:ZENAT
Middle Name:
Last Name:HUSSAINI
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:463 SUMMIT AVE APT D
Mailing Address - Street 2:
Mailing Address - City:PARK RIDGE
Mailing Address - State:IL
Mailing Address - Zip Code:60068-4987
Mailing Address - Country:US
Mailing Address - Phone:248-835-4515
Mailing Address - Fax:
Practice Address - Street 1:463 SUMMIT AVE APT D
Practice Address - Street 2:
Practice Address - City:PARK RIDGE
Practice Address - State:IL
Practice Address - Zip Code:60068-4987
Practice Address - Country:US
Practice Address - Phone:248-835-4515
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-18
Last Update Date:2022-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL135.001043390200000X
IL016.006001213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program