Individual
DR. AMY ZACHARIAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
702 W CHESTNUT ST, BLOOMINGTON, IL 61701-2814
(309) 557-1400
Mailing address
448 WYLIE DR, NORMAL, IL 61761-5405
(888) 924-3786
(309) 268-3649
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
036109906
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036109906
—
IL
01
—
10215111
BLUE CROSS BLUE SHIELD
—
Enumeration date
07/19/2006
Last updated
10/27/2023
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