Provider Demographics
NPI:1508925041
Name:ZANETTI, CLAUDE (MD)
Entity Type:Individual
Prefix:
First Name:CLAUDE
Middle Name:
Last Name:ZANETTI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6547 N AVONDALE #001
Mailing Address - Street 2:
Mailing Address - City:CHGO
Mailing Address - State:IL
Mailing Address - Zip Code:60631
Mailing Address - Country:US
Mailing Address - Phone:773-775-1622
Mailing Address - Fax:773-775-1693
Practice Address - Street 1:5145 N CALIFORNIA
Practice Address - Street 2:
Practice Address - City:CHGO
Practice Address - State:IL
Practice Address - Zip Code:60625
Practice Address - Country:US
Practice Address - Phone:773-878-8200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
C45436Medicare UPIN
IL674140Medicare ID - Type Unspecified