Basic Information
| Provider Information | |||||||||
| NPI: | 1588001754 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ZAHATNANSKY | ||||||||
| FirstName: | JURAJ | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1000 OAKLAND DR | ||||||||
| Address2: | |||||||||
| City: | KALAMAZOO | ||||||||
| State: | MI | ||||||||
| PostalCode: | 490081282 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2693374400 | ||||||||
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| Practice Location | |||||||||
| Address1: | 2040 OGDEN AVE STE 401 | ||||||||
| Address2: | |||||||||
| City: | AURORA | ||||||||
| State: | IL | ||||||||
| PostalCode: | 605047208 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6305857100 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 05/29/2013 | ||||||||
| LastUpdateDate: | 11/18/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 11/18/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RS0010X | 036144480 | IL | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Sports Medicine | 207R00000X | 4301103062 | MI | N | Allopathic & Osteopathic Physicians | Internal Medicine | 390200000X | 4301103062 | MI | N | Student, Health Care | Student in an Organized Health Care Education/Training Program |
No ID Information.