Provider Demographics
NPI:1275627614
Name:CYGAN, ZOFIA (MD)
Entity Type:Individual
Prefix:DR
First Name:ZOFIA
Middle Name:
Last Name:CYGAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5980 ROUTE 53
Mailing Address - Street 2:SUITE B
Mailing Address - City:LISLE
Mailing Address - State:IL
Mailing Address - Zip Code:60532-3199
Mailing Address - Country:US
Mailing Address - Phone:630-355-6040
Mailing Address - Fax:630-968-7716
Practice Address - Street 1:5980 ROUTE 53
Practice Address - Street 2:SUITE B
Practice Address - City:LISLE
Practice Address - State:IL
Practice Address - Zip Code:60532-3199
Practice Address - Country:US
Practice Address - Phone:630-355-6040
Practice Address - Fax:630-968-7716
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-02
Last Update Date:2021-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036074324207QG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QG0300XAllopathic & Osteopathic PhysiciansFamily MedicineGeriatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL3644117376054001Medicaid
C42772Medicare UPIN
769180Medicare ID - Type Unspecified