Provider Demographics
NPI:1922793090
Name:ILLO, ZAINAB
Entity Type:Individual
Prefix:
First Name:ZAINAB
Middle Name:
Last Name:ILLO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1006 OAKCREST ST APT 101
Mailing Address - Street 2:
Mailing Address - City:IOWA CITY
Mailing Address - State:IA
Mailing Address - Zip Code:52246-5138
Mailing Address - Country:US
Mailing Address - Phone:515-227-8225
Mailing Address - Fax:
Practice Address - Street 1:1006 OAKCREST ST APT 101
Practice Address - Street 2:
Practice Address - City:IOWA CITY
Practice Address - State:IA
Practice Address - Zip Code:52246-5138
Practice Address - Country:US
Practice Address - Phone:515-227-8225
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-05
Last Update Date:2023-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer