Provider Demographics
NPI:1649386335
Name:ZABOROWSKI, JOHN MICHAEL (MD)
Entity Type:Individual
Prefix:MR
First Name:JOHN
Middle Name:MICHAEL
Last Name:ZABOROWSKI
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 1:3015 N MILWAUKEE AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60618-6612
Mailing Address - Country:US
Mailing Address - Phone:773-278-6050
Mailing Address - Fax:
Practice Address - Street 1:3015 17 N MILWAUKEE AVE
Practice Address - Street 2:PHYSICIANS CARE CENTER
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60618
Practice Address - Country:US
Practice Address - Phone:773-278-6050
Practice Address - Fax:773-278-4843
Is Sole Proprietor?:No
Enumeration Date:2006-08-22
Last Update Date:2010-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036067925207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036067925OtherBLUE CROSS
ID0021645889OtherBLUE CROSS
IL036067925Medicaid
ILP09812Medicare ID - Type Unspecified
C46022Medicare UPIN