Provider Demographics
NPI:1942482674
Name:AWAN, ZAINAB (OD)
Entity Type:Individual
Prefix:DR
First Name:ZAINAB
Middle Name:
Last Name:AWAN
Suffix:
Gender:F
Credentials:OD
Other - Prefix:DR
Other - First Name:ZAINAB
Other - Middle Name:
Other - Last Name:BAIG
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:OD
Mailing Address - Street 1:1602 ASTOR AVE
Mailing Address - Street 2:
Mailing Address - City:OAKBROOK TERRACE
Mailing Address - State:IL
Mailing Address - Zip Code:60181-5231
Mailing Address - Country:US
Mailing Address - Phone:773-454-5579
Mailing Address - Fax:
Practice Address - Street 1:1254 S CANAL ST
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60607
Practice Address - Country:US
Practice Address - Phone:312-226-0653
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-05
Last Update Date:2018-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL046010015152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist