Provider Demographics
NPI:1912963182
Name:ZEID, JANICE LASKY (MD)
Entity Type:Individual
Prefix:
First Name:JANICE
Middle Name:LASKY
Last Name:ZEID
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:JANICE
Other - Middle Name:B
Other - Last Name:LASKY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:35422 EAGLE WAY
Mailing Address - Street 2:BOX 70
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60678-1354
Mailing Address - Country:US
Mailing Address - Phone:773-880-4000
Mailing Address - Fax:
Practice Address - Street 1:2300 N CHILDRENS PLZ
Practice Address - Street 2:BOX 70
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60614-3363
Practice Address - Country:US
Practice Address - Phone:773-880-4000
Practice Address - Fax:773-880-3025
Is Sole Proprietor?:No
Enumeration Date:2006-04-25
Last Update Date:2007-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL1627123OtherBCBS
ILL64816Medicare PIN
IL1627123OtherBCBS