Provider Demographics
NPI:1457457343
Name:Z HUQ MD FACS LTD
Entity Type:Organization
Organization Name:Z HUQ MD FACS LTD
Other - Org Name:Z HUQ MD FACS LTD
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHYSICIAN/SURGEON
Authorized Official - Prefix:DR
Authorized Official - First Name:Z
Authorized Official - Middle Name:
Authorized Official - Last Name:HUQ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:847-635-6490
Mailing Address - Street 1:241 GOLF MILL CTR
Mailing Address - Street 2:STE 728
Mailing Address - City:NILES
Mailing Address - State:IL
Mailing Address - Zip Code:60714-1224
Mailing Address - Country:US
Mailing Address - Phone:847-635-6490
Mailing Address - Fax:847-635-6491
Practice Address - Street 1:2222 W DIVISION ST
Practice Address - Street 2:STE 225
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60622-2717
Practice Address - Country:US
Practice Address - Phone:773-252-0777
Practice Address - Fax:773-252-0012
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-16
Last Update Date:2008-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL=========OtherFEDERAL TAX ID
IL=========OtherFEDERAL TAX ID