Provider Demographics
NPI:1760560775
Name:ZAMIR, MOSHE (MD)
Entity Type:Individual
Prefix:DR
First Name:MOSHE
Middle Name:
Last Name:ZAMIR
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 1:901 CENTER ST
Mailing Address - Street 2:SUITE 303
Mailing Address - City:ELGIN
Mailing Address - State:IL
Mailing Address - Zip Code:60120-2104
Mailing Address - Country:US
Mailing Address - Phone:847-741-4690
Mailing Address - Fax:847-741-4795
Practice Address - Street 1:901 CENTER ST
Practice Address - Street 2:SUITE 303
Practice Address - City:ELGIN
Practice Address - State:IL
Practice Address - Zip Code:60120-2104
Practice Address - Country:US
Practice Address - Phone:847-741-4690
Practice Address - Fax:847-741-4795
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL36-3102076207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL04500558OtherBLUE SHIELD
IL04500558OtherBLUE SHIELD
ILC38311Medicare UPIN