Provider Demographics
NPI:1033282280
Name:HYDERI, ZEHRA (DPM)
Entity type:Individual
Prefix:
First Name:ZEHRA
Middle Name:
Last Name:HYDERI
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2430 ESPLANADE DR
Mailing Address - Street 2:STE A
Mailing Address - City:ALGONQUIN
Mailing Address - State:IL
Mailing Address - Zip Code:60102-5470
Mailing Address - Country:US
Mailing Address - Phone:847-854-8000
Mailing Address - Fax:847-854-7002
Practice Address - Street 1:2430 ESPLANADE DR
Practice Address - Street 2:STE A
Practice Address - City:ALGONQUIN
Practice Address - State:IL
Practice Address - Zip Code:60102-5470
Practice Address - Country:US
Practice Address - Phone:847-854-8000
Practice Address - Fax:847-854-7002
Is Sole Proprietor?:No
Enumeration Date:2006-11-16
Last Update Date:2017-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL016004893213EP1101X, 213ER0200X, 213ES0000X, 213ES0103X, 213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
No213EP1101XPodiatric Medicine & Surgery Service ProvidersPodiatristPrimary Podiatric Medicine
No213ER0200XPodiatric Medicine & Surgery Service ProvidersPodiatristRadiology
No213ES0000XPodiatric Medicine & Surgery Service ProvidersPodiatristSports Medicine
No213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
U75539Medicare UPIN
IL016004893 3Medicaid
ILK38083214660Medicare PIN