Active NPI
Zamzam Foundation Inc
- Family Medicine Physician
- Wood Dale, IL
National Provider Identifier
1043942238
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- Legal business name
- ZAMZAM FOUNDATION INC
- Practice address
- 343 N Wood Dale Rd
Wood Dale, IL 60191-1578 - Phone
- (917) 348-6408
- NPI assigned
- Jun 27, 2022
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mr. Abdul Maten
- Title
- Ceo
- Phone
- (312) 574-0111
Specialties & licenses 8
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | |||
| Prescribing (Medical) Psychologist | 103TP0016X | |||
| Social Worker | 104100000X | |||
| Family Medicine Physician | 207Q00000X | Primary | ||
| Internal Medicine Physician | 207R00000X | |||
| Pediatrics Physician | 208000000X | |||
| Physical Therapist | 225100000X | |||
| Occupational Therapist | 225X00000X |
Addresses
Primary practice location
343 N Wood Dale Rd
Wood Dale, IL 60191-1578
Mailing address
343 N Wood Dale Rd
Wood Dale, IL 60191-1578
Phone (917) 348-6408
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1656288000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1656288000000",
"number": "1043942238",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "343 N WOOD DALE RD",
"city": "WOOD DALE",
"state": "IL",
"postal_code": "601911578",
"telephone_number": "917-348-6408"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "343 N WOOD DALE RD",
"city": "WOOD DALE",
"state": "IL",
"postal_code": "601911578",
"telephone_number": "917-348-6408"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "ZAMZAM FOUNDATION INC",
"organizational_subpart": "NO",
"enumeration_date": "2022-06-27",
"last_updated": "2022-06-27",
"certification_date": "2022-06-27",
"status": "A",
"authorized_official_last_name": "MATEN",
"authorized_official_first_name": "ABDUL",
"authorized_official_title_or_position": "CEO",
"authorized_official_telephone_number": "312-574-0111",
"authorized_official_name_prefix": "Mr."
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Psychologist",
"state": null,
"license": null,
"primary": false
},
{
"code": "103TP0016X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Psychologist, Prescribing (Medical)",
"state": null,
"license": null,
"primary": false
},
{
"code": "104100000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Social Worker",
"state": null,
"license": null,
"primary": false
},
{
"code": "207Q00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Family Medicine",
"state": null,
"license": null,
"primary": true
},
{
"code": "207R00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Internal Medicine",
"state": null,
"license": null,
"primary": false
},
{
"code": "208000000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Pediatrics",
"state": null,
"license": null,
"primary": false
},
{
"code": "225100000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Physical Therapist",
"state": null,
"license": null,
"primary": false
},
{
"code": "225X00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Occupational Therapist",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Wood Dale, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.