Provider Demographics
NPI:1245227693
Name:ZBIEGIEN, THEODORE FRANCIS JR (MD)
Entity type:Individual
Prefix:DR
First Name:THEODORE
Middle Name:FRANCIS
Last Name:ZBIEGIEN
Suffix:JR
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 2:204
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60631-3745
Mailing Address - Country:US
Mailing Address - Phone:773-467-8950
Mailing Address - Fax:773-467-8949
Practice Address - Street 1:7447 W TALCOTT AVE
Practice Address - Street 2:204
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60631-3745
Practice Address - Country:US
Practice Address - Phone:773-467-8950
Practice Address - Fax:773-467-8949
Is Sole Proprietor?:No
Enumeration Date:2005-09-30
Last Update Date:2010-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036087594207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
F03410Medicare UPIN
IL592290Medicare ID - Type Unspecified