Provider Demographics
NPI:1861506073
Name:ZUMHAGEN, MARK (MD)
Entity Type:Individual
Prefix:DR
First Name:MARK
Middle Name:
Last Name:ZUMHAGEN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:10760W 143RD ST 67
Mailing Address - Street 2:
Mailing Address - City:ORLAND PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60462-1916
Mailing Address - Country:US
Mailing Address - Phone:708-403-7070
Mailing Address - Fax:708-403-3033
Practice Address - Street 1:2000 GOLF RD
Practice Address - Street 2:
Practice Address - City:ROLLING MEADOWS
Practice Address - State:IL
Practice Address - Zip Code:60008-4216
Practice Address - Country:US
Practice Address - Phone:847-981-1881
Practice Address - Fax:847-981-0411
Is Sole Proprietor?:No
Enumeration Date:2006-08-18
Last Update Date:2015-08-13
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IL036-073343207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine