Provider Demographics
NPI:1104002476
Name:ZIRA MIND AND BODY CENTER, LTD
Entity Type:Organization
Organization Name:ZIRA MIND AND BODY CENTER, LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:TRUPTI
Authorized Official - Middle Name:BINAL
Authorized Official - Last Name:GOKANI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:847-975-6787
Mailing Address - Street 1:333 WAUKEGAN RD STE E
Mailing Address - Street 2:
Mailing Address - City:GLENVIEW
Mailing Address - State:IL
Mailing Address - Zip Code:60025-5122
Mailing Address - Country:US
Mailing Address - Phone:224-442-3060
Mailing Address - Fax:224-765-7300
Practice Address - Street 1:1332 WAUKEGAN ROAD
Practice Address - Street 2:
Practice Address - City:GLENVIEW
Practice Address - State:IL
Practice Address - Zip Code:60025
Practice Address - Country:US
Practice Address - Phone:224-521-1212
Practice Address - Fax:224-521-1216
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-16
Last Update Date:2018-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL0361054582084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILH77084Medicare UPIN
IL213059Medicare PIN