Provider Demographics
NPI:1487844098
Name:BANNA, ZINA SHOLJI (MD)
Entity Type:Individual
Prefix:
First Name:ZINA
Middle Name:SHOLJI
Last Name:BANNA
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 1:7100 CARPENTER RD
Mailing Address - Street 2:
Mailing Address - City:SKOKIE
Mailing Address - State:IL
Mailing Address - Zip Code:60077-3279
Mailing Address - Country:US
Mailing Address - Phone:847-673-5166
Mailing Address - Fax:847-673-5636
Practice Address - Street 1:7100 CARPENTER RD
Practice Address - Street 2:
Practice Address - City:SKOKIE
Practice Address - State:IL
Practice Address - Zip Code:60077-3279
Practice Address - Country:US
Practice Address - Phone:847-673-5166
Practice Address - Fax:847-673-5636
Is Sole Proprietor?:No
Enumeration Date:2007-07-30
Last Update Date:2008-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036119135207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine