Provider Demographics
NPI:1598937062
Name:ZOFIA CYGAN M.D.SC
Entity Type:Organization
Organization Name:ZOFIA CYGAN M.D.SC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SIGNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ZOFIA
Authorized Official - Middle Name:
Authorized Official - Last Name:CYGAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:639-355-6040
Mailing Address - Street 1:5980 ROUTE 53 STE B
Mailing Address - Street 2:
Mailing Address - City:LISLE
Mailing Address - State:IL
Mailing Address - Zip Code:60532-3389
Mailing Address - Country:US
Mailing Address - Phone:630-355-6040
Mailing Address - Fax:
Practice Address - Street 1:5980 ROUTE 53 STE B
Practice Address - Street 2:
Practice Address - City:LISLE
Practice Address - State:IL
Practice Address - Zip Code:60532-3389
Practice Address - Country:US
Practice Address - Phone:630-355-6040
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-25
Last Update Date:2021-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036074324207QG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207QG0300XAllopathic & Osteopathic PhysiciansFamily MedicineGeriatric MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILC42772Medicare UPIN