Provider Demographics
NPI:1467422451
Name:ZAK, RICHARD D (MD)
Entity Type:Individual
Prefix:
First Name:RICHARD
Middle Name:D
Last Name:ZAK
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:1300 N HIGHLAND AVE
Mailing Address - Street 2:STE 1
Mailing Address - City:AURORA
Mailing Address - State:IL
Mailing Address - Zip Code:60506
Mailing Address - Country:US
Mailing Address - Phone:630-897-5104
Mailing Address - Fax:630-897-5089
Practice Address - Street 1:1300 N HIGHLAND AVE
Practice Address - Street 2:STE 1
Practice Address - City:AURORA
Practice Address - State:IL
Practice Address - Zip Code:60506
Practice Address - Country:US
Practice Address - Phone:630-897-5104
Practice Address - Fax:630-897-5089
Is Sole Proprietor?:No
Enumeration Date:2006-01-24
Last Update Date:2008-02-28
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IL207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL0434070001OtherADMINISTAR
IL4216782OtherAETNA
IL34540225OtherBCBS
A72543Medicare UPIN