Basic Information
| Provider Information | |||||||||
| NPI: | 1629064290 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | ZIKAINIM INC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3737 W ARTHUR AVE | ||||||||
| Address2: | |||||||||
| City: | LINCOLNWOOD | ||||||||
| State: | IL | ||||||||
| PostalCode: | 607124029 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8476792121 | ||||||||
| FaxNumber: | 8476792121 | ||||||||
| Practice Location | |||||||||
| Address1: | 5448 N BROADWAY ST | ||||||||
| Address2: | |||||||||
| City: | CHICAGO | ||||||||
| State: | IL | ||||||||
| PostalCode: | 606401704 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7733342224 | ||||||||
| FaxNumber: | 7733340360 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/20/2005 | ||||||||
| LastUpdateDate: | 06/04/2015 | ||||||||
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| AuthorizedOfficialLastName: | WENGROW | ||||||||
| AuthorizedOfficialFirstName: | HOWARD | ||||||||
| AuthorizedOfficialMiddleName: | L. | ||||||||
| AuthorizedOfficialTitleorPosition: | VICE PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 8476792121 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MR. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 314000000X | 0026294 | IL | Y | Nursing & Custodial Care Facilities | Skilled Nursing Facility |
No ID Information.