Provider Demographics
NPI:1598939886
Name:ZAFEER BERKI
Entity Type:Organization
Organization Name:ZAFEER BERKI
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ZAFEER
Authorized Official - Middle Name:H K
Authorized Official - Last Name:BERKI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:847-984-0585
Mailing Address - Street 1:PO BOX 597
Mailing Address - Street 2:
Mailing Address - City:LOCKPORT
Mailing Address - State:IL
Mailing Address - Zip Code:60441-0597
Mailing Address - Country:US
Mailing Address - Phone:847-984-0585
Mailing Address - Fax:
Practice Address - Street 1:1 TIFFANY PT
Practice Address - Street 2:SUITE # 110
Practice Address - City:BLOOMINGDALE
Practice Address - State:IL
Practice Address - Zip Code:60108-2936
Practice Address - Country:US
Practice Address - Phone:847-984-0585
Practice Address - Fax:847-908-7564
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-17
Last Update Date:2011-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL0360940902084P0800X, 283Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
No283Q00000XHospitalsPsychiatric HospitalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036094090Medicaid
IL216125Medicare PIN
IL216124Medicare PIN