Provider Demographics
NPI:1548983877
Name:AZ CHIROPRACTIC PLLC
Entity type:Organization
Organization Name:AZ CHIROPRACTIC PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:
Authorized Official - Last Name:ZANAYED
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:708-840-1600
Mailing Address - Street 1:15000 CICERO AVE STE 100
Mailing Address - Street 2:
Mailing Address - City:OAK FOREST
Mailing Address - State:IL
Mailing Address - Zip Code:60452-1480
Mailing Address - Country:US
Mailing Address - Phone:708-840-1600
Mailing Address - Fax:
Practice Address - Street 1:15000 CICERO AVE STE 100
Practice Address - Street 2:
Practice Address - City:OAK FOREST
Practice Address - State:IL
Practice Address - Zip Code:60452-1480
Practice Address - Country:US
Practice Address - Phone:708-407-9393
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-09-21
Last Update Date:2022-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL1063146744OtherAETNA
IL1063146744OtherUNITED HEALTH CARE
IL1063146744Medicaid
IL1063146744OtherBCBS