Individual
PETER THOMAS ZAVISLAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
600 S PAULINA ST, CHICAGO, IL 60612-3806
(312) 942-5495
Mailing address
1650 W HARRISON ST, SUITE 466, CHICAGO, IL 60612-3800
(312) 942-5000
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
01079931A
IN
207L00000X
Anesthesiology Physician
Primary
036135255
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000001566166
ANTHEM PTAN
IN
01
—
1102571187
ANTHEM PTAN
IN
05
—
300015863
—
IN
Enumeration date
06/17/2011
Last updated
11/21/2024
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