Provider Demographics
NPI:1578138350
Name:MAHAJAN, ZUBIN AJAY (MD)
Entity Type:Individual
Prefix:MR
First Name:ZUBIN
Middle Name:AJAY
Last Name:MAHAJAN
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:LOYOLA MEDICINE MACNEAL HOSPITAL 3249 SOUTH OAK PARK AV
Mailing Address - Street 2:
Mailing Address - City:BERWYN
Mailing Address - State:IL
Mailing Address - Zip Code:60402
Mailing Address - Country:US
Mailing Address - Phone:708-783-3401
Mailing Address - Fax:
Practice Address - Street 1:MACNEAL CENTER FOR INTERNAL MEDICINE 3722 SOUTH HARLEM
Practice Address - Street 2:SUITE LL34
Practice Address - City:RIVERSIDE
Practice Address - State:IL
Practice Address - Zip Code:60546
Practice Address - Country:US
Practice Address - Phone:708-783-6566
Practice Address - Fax:708-783-6567
Is Sole Proprietor?:No
Enumeration Date:2021-05-24
Last Update Date:2024-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036-168223207R00000X
IL125-078082207R00000X
390200000X
IL036.168223207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program