| NPI Details | |
|---|---|
| NPI | 1073908901 |
| Gender | Male |
| Enumeration Date | 03/30/2015 |
| Last Updated | 07/27/2015 |
| Entity Type | Individual |
| Active | Over 3 years ago |
| Practice Location | |
|---|---|
| 2160 S 1ST AVE BUILDING 105, SUITE 1814 MAYWOOD IL, 60153-3328, US |
|
| Phone | (888) 584-7888 |
| Fax | (708) 216-5560 |
| Business Location | |
|---|---|
| 2160 S 1ST AVE MAYWOOD IL, 60153-3328, US |
|
| Phone | |
| Fax | |
| Toxanomy | |
|---|---|
| Taxonomy Code | 390200000X |
| License State | |
| License Number | |
| Remove 1073908901 NPI Number | |
According to our database, Zachary Jordan Weiss NPI is 1073908901, taxonomy code is 390200000X Zachary Jordan Weiss physically located at 2160 S 1st Ave, Maywood IL, 60153-3328. NPI Number Zachary Jordan Weiss has the Individual type.
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1073908901 NPI number is provided on an as is basis without warranty of any kind. 1073908901 is maintained by the National Plan & Provider Enumeration System. The contents of Zachary Jordan Weiss are for informational purposes only.
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