Provider Demographics
NPI:1760477889
Name:ZALLIK, NED I (MD)
Entity type:Individual
Prefix:DR
First Name:NED
Middle Name:I
Last Name:ZALLIK
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 1:2101 WAUKEGAN RD STE 303
Mailing Address - Street 2:
Mailing Address - City:BANNOCKBURN
Mailing Address - State:IL
Mailing Address - Zip Code:60015-1836
Mailing Address - Country:US
Mailing Address - Phone:224-496-6772
Mailing Address - Fax:224-298-0624
Practice Address - Street 1:2101 WAUKEGAN RD STE 303
Practice Address - Street 2:
Practice Address - City:BANNOCKBURN
Practice Address - State:IL
Practice Address - Zip Code:60015-1836
Practice Address - Country:US
Practice Address - Phone:224-496-6772
Practice Address - Fax:224-298-0624
Is Sole Proprietor?:No
Enumeration Date:2005-09-14
Last Update Date:2025-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036067649207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036067649Medicaid
ILC41611Medicare UPIN
IL036067649Medicaid