Provider Demographics
NPI:1982897047
Name:MACHUT, KERRI ZIMMERMAN (MD)
Entity Type:Individual
Prefix:DR
First Name:KERRI
Middle Name:ZIMMERMAN
Last Name:MACHUT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:225 E CHICAGO AVE # 45
Mailing Address - Street 2:DIVISION OF NEONATOLOGY
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60611-2605
Mailing Address - Country:US
Mailing Address - Phone:312-227-4190
Mailing Address - Fax:
Practice Address - Street 1:225 E CHICAGO AVE # 45
Practice Address - Street 2:DIVISION OF NEONATOLOGY
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60611-2605
Practice Address - Country:US
Practice Address - Phone:312-227-4190
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-08-22
Last Update Date:2012-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036.1175982080N0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080N0001XAllopathic & Osteopathic PhysiciansPediatricsNeonatal-Perinatal Medicine