Provider Demographics
NPI:1356544944
Name:PERSONAL DOCTOR OLGA ZARKH MD LTD
Entity type:Organization
Organization Name:PERSONAL DOCTOR OLGA ZARKH MD LTD
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:OLGA
Authorized Official - Middle Name:
Authorized Official - Last Name:ZARKH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:847-818-7700
Mailing Address - Street 1:135 N ARLINGTON HEIGHTS RD STE 160
Mailing Address - Street 2:
Mailing Address - City:BUFFALO GROVE
Mailing Address - State:IL
Mailing Address - Zip Code:60089-8216
Mailing Address - Country:US
Mailing Address - Phone:847-818-7700
Mailing Address - Fax:848-818-1718
Practice Address - Street 1:135 N ARLINGTON HEIGHTS RD STE 160
Practice Address - Street 2:
Practice Address - City:BUFFALO GROVE
Practice Address - State:IL
Practice Address - Zip Code:60089-8216
Practice Address - Country:US
Practice Address - Phone:847-818-7700
Practice Address - Fax:848-818-1718
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-09
Last Update Date:2024-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036109468261QM1300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL215251Medicare PIN