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Individual

DR. JACK S. ZOLDAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
5015 N PAULINA ST, SUITE 315, CHICAGO, IL 60640-2756
(773) 561-6573
(773) 561-8323
Mailing address
5015 N PAULINA ST, SUITE 315, CHICAGO, IL 60640-2756
(773) 561-6573
(773) 561-8323

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
036053375
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
036053375
IL
Enumeration date
03/30/2006
Last updated
02/17/2010
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