Provider Demographics
NPI:1619064151
Name:ZAYAN, MAYER (MD)
Entity Type:Individual
Prefix:
First Name:MAYER
Middle Name:
Last Name:ZAYAN
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 1:3605 WOODHEAD DR STE 111
Mailing Address - Street 2:
Mailing Address - City:NORTHBROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60062-1850
Mailing Address - Country:US
Mailing Address - Phone:800-564-5270
Mailing Address - Fax:877-432-7816
Practice Address - Street 1:3605 WOODHEAD DR STE 111
Practice Address - Street 2:
Practice Address - City:NORTHBROOK
Practice Address - State:IL
Practice Address - Zip Code:60062-1850
Practice Address - Country:US
Practice Address - Phone:800-564-5270
Practice Address - Fax:877-432-7816
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-06
Last Update Date:2022-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036060803207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036060803Medicaid
IL1619064151Medicaid
IL036060803Medicaid
ILK50959Medicare PIN