Provider Demographics
NPI:1326046681
Name:ZUK, OLGA (MD)
Entity Type:Individual
Prefix:
First Name:OLGA
Middle Name:
Last Name:ZUK
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6923 W SHAKESPEARE AVE
Mailing Address - Street 2:#2
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60707-3355
Mailing Address - Country:US
Mailing Address - Phone:773-385-6529
Mailing Address - Fax:773-385-6673
Practice Address - Street 1:5140 N CALIFORNIA AVE
Practice Address - Street 2:SUITE 115
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60625-3645
Practice Address - Country:US
Practice Address - Phone:773-989-3803
Practice Address - Fax:773-878-5726
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-11
Last Update Date:2011-05-24
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IL036070498207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILK36740OtherMEDICARE PERFORMING PROVIDER ID
IL036070498Medicaid
IL922001Medicare PIN
ILE43567Medicare UPIN