Provider Demographics
NPI:1629732292
Name:ZAMYAD, NEGIN
Entity type:Individual
Prefix:
First Name:NEGIN
Middle Name:
Last Name:ZAMYAD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:225 N COLUMBUS DR APT 5203
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60601-5233
Mailing Address - Country:US
Mailing Address - Phone:872-220-3287
Mailing Address - Fax:
Practice Address - Street 1:225 N COLUMBUS DR APT 5203
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60601-5233
Practice Address - Country:US
Practice Address - Phone:872-220-3287
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-10-28
Last Update Date:2021-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL051304423183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist