Provider Demographics
NPI:1154376572
Name:MERCHANT, ZARINA I (MD)
Entity type:Individual
Prefix:
First Name:ZARINA
Middle Name:I
Last Name:MERCHANT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2551 W PETERSON AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60659-4019
Mailing Address - Country:US
Mailing Address - Phone:773-747-3900
Mailing Address - Fax:773-754-4350
Practice Address - Street 1:2655 W PETERSON AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60659-4017
Practice Address - Country:US
Practice Address - Phone:773-271-8880
Practice Address - Fax:773-271-7435
Is Sole Proprietor?:No
Enumeration Date:2006-05-24
Last Update Date:2014-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA74869208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
367830Medicare PIN