Provider Demographics
NPI:1427615277
Name:ZASADNY, PIOTR (DO)
Entity type:Individual
Prefix:DR
First Name:PIOTR
Middle Name:
Last Name:ZASADNY
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2650 RIDGE AVE STE 1223
Mailing Address - Street 2:
Mailing Address - City:EVANSTON
Mailing Address - State:IL
Mailing Address - Zip Code:60201-1700
Mailing Address - Country:US
Mailing Address - Phone:847-982-6715
Mailing Address - Fax:
Practice Address - Street 1:5215 N CALIFORNIA AVE STE F603
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60625-8564
Practice Address - Country:US
Practice Address - Phone:773-878-3627
Practice Address - Fax:773-878-0985
Is Sole Proprietor?:No
Enumeration Date:2019-05-28
Last Update Date:2022-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL125073890207Q00000X
IL036160502207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL125073890OtherIDFPR