Provider Demographics
NPI:1194761411
Name:DR ZAVERI & ASSOCIATES SC
Entity type:Organization
Organization Name:DR ZAVERI & ASSOCIATES SC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SELF EMPLOYED PHYSICIAN PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SHAILESH
Authorized Official - Middle Name:C
Authorized Official - Last Name:ZAVERI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:847-301-1212
Mailing Address - Street 1:800 E WOODFIELD RD STE 111
Mailing Address - Street 2:
Mailing Address - City:SCHAUMBURG
Mailing Address - State:IL
Mailing Address - Zip Code:60173-4763
Mailing Address - Country:US
Mailing Address - Phone:847-301-1212
Mailing Address - Fax:847-301-1277
Practice Address - Street 1:800 E WOODFIELD RD
Practice Address - Street 2:SUITE #111
Practice Address - City:SCHAUMBURG
Practice Address - State:IL
Practice Address - Zip Code:60173-4717
Practice Address - Country:US
Practice Address - Phone:847-301-1212
Practice Address - Fax:847-301-1212
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-22
Last Update Date:2014-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036059482207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036059482Medicaid
ILL72657Medicare ID - Type Unspecified
IL036059482Medicaid