Zishan Alam, D.O.
Individual provider Active NPI Family Medicine Physician · Buffalo Grove, IL
NPI 1295786754 · NPPES record last updated Oct 14, 2010
Key facts
- NPI
- 1295786754
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 036115864 (IL)
- Practice address
- 985 S Buffalo Grove Rd
Buffalo Grove, IL 60089 - Phone
- (847) 541-4878
- NPI assigned
- May 12, 2006
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
- Opted out of Medicare
- Yes, effective Jan 1, 2017 through Jan 1, 2027
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036115864 | IL | MD | Family Medicine Physician |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 036115864 | IL | Yes |
Addresses
Primary practice location
985 S Buffalo Grove Rd
Buffalo Grove, IL 60089
Mailing address
750 N. Summit LN.
Vernon Hills, IL 60061
Phone (773) 315-6240
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 036115864 | Other | IL | STATE LICENSE |
Other providers in Buffalo Grove, IL
- Garry Airapetov
- Alexa Akana
- Bahia Al-Salihi
- Aseel Alaabed
- Azza Farrag Alalwee
- Alan Auerbach MD
- Alan Optical PLLC
- Melanie Ilysa Albaum
- Megan E Albert
- Matthew Aldana
All providers in Buffalo Grove, IL · Family Medicine Physician in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 14, 2010. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Opt Out Affidavits (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.