Provider Demographics
NPI:1720602147
Name:ZIENTARSKI, ALAN
Entity Type:Individual
Prefix:
First Name:ALAN
Middle Name:
Last Name:ZIENTARSKI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8616 STEEPLE HILL DR
Mailing Address - Street 2:
Mailing Address - City:HICKORY HILLS
Mailing Address - State:IL
Mailing Address - Zip Code:60457-1037
Mailing Address - Country:US
Mailing Address - Phone:708-420-4266
Mailing Address - Fax:
Practice Address - Street 1:8616 STEEPLE HILL DR
Practice Address - Street 2:
Practice Address - City:HICKORY HILLS
Practice Address - State:IL
Practice Address - Zip Code:60457-1037
Practice Address - Country:US
Practice Address - Phone:708-420-4266
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-06-01
Last Update Date:2020-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program