Provider Demographics
NPI:1740898154
Name:ANJUM, ZEESHAN (DMD)
Entity type:Individual
Prefix:DR
First Name:ZEESHAN
Middle Name:
Last Name:ANJUM
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2322 S CANAL ST UNIT 402
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60616-2021
Mailing Address - Country:US
Mailing Address - Phone:914-325-4135
Mailing Address - Fax:
Practice Address - Street 1:2322 S CANAL ST UNIT 402
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60616-2021
Practice Address - Country:US
Practice Address - Phone:914-325-4135
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-22
Last Update Date:2020-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL019.032739122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist