Provider Demographics
NPI:1770769465
Name:MALIK ZAYED DPM
Entity type:Organization
Organization Name:MALIK ZAYED DPM
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:MALIK
Authorized Official - Middle Name:
Authorized Official - Last Name:ZAYED
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:773-725-2953
Mailing Address - Street 1:3631 N HARLEM AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60634-2237
Mailing Address - Country:US
Mailing Address - Phone:773-725-2953
Mailing Address - Fax:773-725-2932
Practice Address - Street 1:3631 N HARLEM AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60634-2237
Practice Address - Country:US
Practice Address - Phone:773-725-2953
Practice Address - Fax:773-725-2932
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-14
Last Update Date:2024-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL016004788213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILU64808Medicare UPIN
IL220890Medicare PIN
IL4500650001Medicare NSC