Basic Information
| Provider Information | |||||||||
| NPI: | 1073928164 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ZOBENS | ||||||||
| FirstName: | ZACHARY | ||||||||
| MiddleName: | ALEXANDER | ||||||||
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| Credential: | DPM | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2029 W EVERGREEN AVE | ||||||||
| Address2: | APT 1E | ||||||||
| City: | CHICAGO | ||||||||
| State: | IL | ||||||||
| PostalCode: | 606221908 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2244064930 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1299 REAVIS BARRACKS RD | ||||||||
| Address2: | |||||||||
| City: | SAINT LOUIS | ||||||||
| State: | MO | ||||||||
| PostalCode: | 631253260 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3144879300 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 06/26/2014 | ||||||||
| LastUpdateDate: | 04/13/2017 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 213ES0103X | 135000849 | IL | N | Podiatric Medicine & Surgery Service Providers | Podiatrist | Foot & Ankle Surgery | 213ES0103X | 2017010428 | MO | Y | Podiatric Medicine & Surgery Service Providers | Podiatrist | Foot & Ankle Surgery |
No ID Information.