Provider Demographics
NPI:1720047012
Name:ZARY, DIANE MARIE (DC)
Entity Type:Individual
Prefix:DR
First Name:DIANE
Middle Name:MARIE
Last Name:ZARY
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:231 S GRANT ST
Mailing Address - Street 2:
Mailing Address - City:WESTMONT
Mailing Address - State:IL
Mailing Address - Zip Code:60559-1909
Mailing Address - Country:US
Mailing Address - Phone:630-455-5640
Mailing Address - Fax:
Practice Address - Street 1:82 63RD ST
Practice Address - Street 2:
Practice Address - City:WILLOW BROOK
Practice Address - State:IL
Practice Address - Zip Code:60527-2982
Practice Address - Country:US
Practice Address - Phone:630-455-5640
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-03-23
Last Update Date:2008-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038-008043111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL02223321OtherBLUE CROSS BLUE SHIELD
IL208997OtherMEDICARE GROUP NUMBER
ILK06480Medicare ID - Type Unspecified
IL208997OtherMEDICARE GROUP NUMBER