Provider Demographics
NPI:1710118419
Name:KEVIN OLIVER ZWEIG MD SC
Entity Type:Organization
Organization Name:KEVIN OLIVER ZWEIG MD SC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:OLIVER
Authorized Official - Last Name:ZWEIG
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:708-425-6800
Mailing Address - Street 1:2850 W 95TH ST
Mailing Address - Street 2:SUITE 12
Mailing Address - City:EVERGREEN PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60805-2735
Mailing Address - Country:US
Mailing Address - Phone:708-425-6800
Mailing Address - Fax:
Practice Address - Street 1:2850 W 95TH ST
Practice Address - Street 2:SUITE 12
Practice Address - City:EVERGREEN PARK
Practice Address - State:IL
Practice Address - Zip Code:60805-2735
Practice Address - Country:US
Practice Address - Phone:708-425-6800
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-07-30
Last Update Date:2009-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036062511207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
716800Medicare PIN
C45900Medicare PIN
0756440001Medicare NSC
C45900Medicare UPIN