Basic Information
| Provider Information | |||||||||
| NPI: | 1508095605 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ZAIDI | ||||||||
| FirstName: | FARHAN | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 444 N NORTHWEST HWY STE 206 | ||||||||
| Address2: | |||||||||
| City: | PARK RIDGE | ||||||||
| State: | IL | ||||||||
| PostalCode: | 600683271 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8476536184 | ||||||||
| FaxNumber: | 8476967932 | ||||||||
| Practice Location | |||||||||
| Address1: | 444 N NORTHWEST HWY STE 206 | ||||||||
| Address2: | |||||||||
| City: | PARK RIDGE | ||||||||
| State: | IL | ||||||||
| PostalCode: | 60068 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8476536184 | ||||||||
| FaxNumber: | 8476967932 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/09/2009 | ||||||||
| LastUpdateDate: | 07/10/2018 | ||||||||
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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 | 207RP1001X | 036134427 | IL | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Pulmonary Disease |
ID Information
| ID | Type | State | Issuer | Description | 363391284 | 01 | IL | TAX ID | OTHER | 036134427 | 05 | IL | MEDICAID |