Provider Demographics
NPI:1336350560
Name:ZAMAN, ZAKIA SALAM (MD)
Entity Type:Individual
Prefix:DR
First Name:ZAKIA
Middle Name:SALAM
Last Name:ZAMAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1549 SPRUCE CT
Mailing Address - Street 2:
Mailing Address - City:LOMBARD
Mailing Address - State:IL
Mailing Address - Zip Code:60148-4245
Mailing Address - Country:US
Mailing Address - Phone:630-242-1747
Mailing Address - Fax:866-261-3402
Practice Address - Street 1:1196 S MAIN ST STE F
Practice Address - Street 2:
Practice Address - City:LOMBARD
Practice Address - State:IL
Practice Address - Zip Code:60148-3939
Practice Address - Country:US
Practice Address - Phone:630-916-3000
Practice Address - Fax:630-916-3253
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-28
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036096424208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036096424Medicaid