Provider Demographics
NPI:1295571289
Name:ANSARI, ZAMAN ALI
Entity type:Individual
Prefix:
First Name:ZAMAN
Middle Name:ALI
Last Name:ANSARI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5600 N RIVER RD STE 800
Mailing Address - Street 2:
Mailing Address - City:ROSEMONT
Mailing Address - State:IL
Mailing Address - Zip Code:60018-5166
Mailing Address - Country:US
Mailing Address - Phone:872-806-5630
Mailing Address - Fax:
Practice Address - Street 1:5600 N RIVER RD STE 800
Practice Address - Street 2:
Practice Address - City:ROSEMONT
Practice Address - State:IL
Practice Address - Zip Code:60018-5166
Practice Address - Country:US
Practice Address - Phone:872-806-5630
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-08
Last Update Date:2024-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies