Zisansha Zahirsha, | |
2160 S 1st Ave, Maywood, IL 60153-3328 | |
(708) 216-4533 | |
(708) 216-5446 |
Full Name | Zisansha Zahirsha |
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Gender | Male |
Speciality | Dermatology |
Location | 2160 S 1st Ave, Maywood, Illinois |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1144859372 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207N00000X | Dermatology | 125.075813 (Illinois) | Primary |
Entity Name | Skin Dermatology, Llc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1386399749 PECOS PAC ID: 5991187577 Enrollment ID: O20220728001977 |
Mailing Address | Practice Location Address |
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Zisansha Zahirsha, 2160 S 1st Ave, Maywood, IL 60153-3328 Ph: () - | Zisansha Zahirsha, 2160 S 1st Ave, Maywood, IL 60153-3328 Ph: (708) 216-4533 |
Lauren Moy, M.D. Dermatology Medicare: Medicare Enrolled Practice Location: 2160 S 1st Ave, Maywood, IL 60153 Phone: 708-216-9000 | |
James Swan, MD Dermatology Medicare: Medicare Enrolled Practice Location: 2160 S 1st Ave, (321 Lagrange Rd., Lagrande Park, Il.60526), Maywood, IL 60153 Phone: 708-485-1020 Fax: 708-485-1173 | |
Dr. Jenna Janiga Lullo, M.D. Dermatology Medicare: Accepting Medicare Assignments Practice Location: 2160 S 1st Ave, Maywood, IL 60153 Phone: 708-216-9000 | |
Dr. Lissette Carmen Ortiz-ferrer, M.D. Dermatology Medicare: Not Enrolled in Medicare Practice Location: 2160 S 1st Ave, Building 101, Room 1752, Maywood, IL 60153 Phone: 708-216-9000 Fax: 708-216-6269 | |
Edgar Anderson, MD Dermatology Medicare: Not Enrolled in Medicare Practice Location: 1160 S 1st Ave, Loyola University Medical Center 101-1740, Maywood, IL 60153 Phone: 708-216-9000 Fax: 708-216-9033 | |
Wendy Kim, DO Dermatology Medicare: Accepting Medicare Assignments Practice Location: 2160 S 1st Ave, Maywood, IL 60153 Phone: 708-216-9000 |