| Doctor Name: | ANCY ZACHARIA |
| NPI Number: | 1053450494 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | NP |
| License Number: | 041287164 |
| Business Practice Address: | 1800 N Main St Second Floor Wheaton, IL - 601873112 |
| Business Phone Number: | 6306144960 |
| Business Fax Number: | 6306823727 |
| Mailing Address: | 1800 N Main St, Second Floor WHEATON |
| State: | IL |
| Postal Code: | 601873112 |
| Phone Number: | 6306144960 |
| Fax Number: | 6306823727 |
| NPI Enumeration Date: | 02/05/2007 |
| NPI Last Update Date: | 04/15/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LG0600X |
| License Number: | 041287164 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | IL |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Gerontology |
| Taxonomy Definition: | |