Provider Demographics
NPI:1760477889
Name:ZALLIK, NED I (MD)
Entity Type:Individual
Prefix:DR
First Name:NED
Middle Name:I
Last Name:ZALLIK
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:800 N WESTMORELAND RD
Mailing Address - Street 2:SUITE 201
Mailing Address - City:LAKE FOREST
Mailing Address - State:IL
Mailing Address - Zip Code:60045-1673
Mailing Address - Country:US
Mailing Address - Phone:847-926-0106
Mailing Address - Fax:312-694-1155
Practice Address - Street 1:800 N WESTMORELAND RD
Practice Address - Street 2:SUITE 201
Practice Address - City:LAKE FOREST
Practice Address - State:IL
Practice Address - Zip Code:60045-1673
Practice Address - Country:US
Practice Address - Phone:847-926-0106
Practice Address - Fax:312-694-1155
Is Sole Proprietor?:No
Enumeration Date:2005-09-14
Last Update Date:2013-01-15
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IL036067649207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036067649Medicaid
ILC41611Medicare UPIN
IL036067649Medicaid