Provider Demographics
NPI:1871582486
Name:ANIOL, ZBIGNIEW (MD)
Entity type:Individual
Prefix:
First Name:ZBIGNIEW
Middle Name:
Last Name:ANIOL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7447 W TALCOTT AVE
Mailing Address - Street 2:SUITE 405
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60631-3745
Mailing Address - Country:US
Mailing Address - Phone:773-774-4000
Mailing Address - Fax:773-774-2129
Practice Address - Street 1:7447 W TALCOTT AVE
Practice Address - Street 2:SUITE 405
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60631-3745
Practice Address - Country:US
Practice Address - Phone:773-774-4000
Practice Address - Fax:773-774-2129
Is Sole Proprietor?:No
Enumeration Date:2005-10-17
Last Update Date:2012-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036090656207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036090656Medicaid
IL036090656Medicaid
ILK04355Medicare ID - Type Unspecified