Provider Demographics
NPI:1508095605
Name:ZAIDI, FARHAN (MD)
Entity type:Individual
Prefix:DR
First Name:FARHAN
Middle Name:
Last Name:ZAIDI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:444 N NORTHWEST HWY STE 206
Mailing Address - Street 2:
Mailing Address - City:PARK RIDGE
Mailing Address - State:IL
Mailing Address - Zip Code:60068-3271
Mailing Address - Country:US
Mailing Address - Phone:847-653-6184
Mailing Address - Fax:847-696-7932
Practice Address - Street 1:444 N NORTHWEST HWY STE 206
Practice Address - Street 2:
Practice Address - City:PARK RIDGE
Practice Address - State:IL
Practice Address - Zip Code:60068
Practice Address - Country:US
Practice Address - Phone:847-653-6184
Practice Address - Fax:847-696-7932
Is Sole Proprietor?:No
Enumeration Date:2009-07-09
Last Update Date:2018-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036134427207RP1001X
PAMD445069207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL363391284OtherTAX ID
IL036134427Medicaid