Provider Demographics
NPI:1316491533
Name:PHYO, ZAW WIN (MB,BS)
Entity type:Individual
Prefix:
First Name:ZAW
Middle Name:WIN
Last Name:PHYO
Suffix:
Gender:
Credentials:MB,BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1300 FRANKLIN AVE STE 380
Mailing Address - Street 2:
Mailing Address - City:NORMAL
Mailing Address - State:IL
Mailing Address - Zip Code:61761-4266
Mailing Address - Country:US
Mailing Address - Phone:309-268-3598
Mailing Address - Fax:309-268-2536
Practice Address - Street 1:1300 FRANKLIN AVE STE 380
Practice Address - Street 2:
Practice Address - City:NORMAL
Practice Address - State:IL
Practice Address - Zip Code:61761-4266
Practice Address - Country:US
Practice Address - Phone:309-268-3598
Practice Address - Fax:309-268-2536
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-04
Last Update Date:2025-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
IL036.148955207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program