Provider Demographics
NPI:1881924702
Name:ZAIDI, FAWWAD I (MD)
Entity type:Individual
Prefix:
First Name:FAWWAD
Middle Name:I
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 1:10350 HALIGUS RD STE 120
Mailing Address - Street 2:
Mailing Address - City:HUNTLEY
Mailing Address - State:IL
Mailing Address - Zip Code:60142-9526
Mailing Address - Country:US
Mailing Address - Phone:847-802-7480
Mailing Address - Fax:847-802-7485
Practice Address - Street 1:10350 HALIGUS RD STE 120
Practice Address - Street 2:
Practice Address - City:HUNTLEY
Practice Address - State:IL
Practice Address - Zip Code:60142-9526
Practice Address - Country:US
Practice Address - Phone:847-802-7480
Practice Address - Fax:847-802-7485
Is Sole Proprietor?:No
Enumeration Date:2009-12-29
Last Update Date:2024-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036.128533207RH0003X
IL036128533207R00000X, 208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL23364OtherSAINT JOSEPH HOSPITAL , CHICAGO, ILLINOIS.