Individual
OMEED ZARDKOOHI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
25 N WINFIELD RD, WINFIELD, IL 60190-1295
(630) 232-0280
(630) 232-3895
Mailing address
351 DELNOR DR STE 302, GENEVA, IL 60134-4233
(630) 202-0280
(630) 232-3895
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
L-225514
MA
207RC0000X
Cardiovascular Disease Physician
036132874
IL
207RC0001X
Clinical Cardiac Electrophysiology Physician
Primary
036132874
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036132874
—
IL
01
—
206147
MEDICARE PTAN (GROUP)
IL
01
—
206147253
MEDICARE PTAN (INDIVIDUAL)
IL
01
—
CA4748
MEDICARE RAILROAD (GROUP PTAN)
IL
01
—
P01209469
MEDICARE RAILROAD (PROVIDER PTAN)
IL
Enumeration date
02/27/2007
Last updated
07/30/2024
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