| Organization Name: | ZIGMA VISITING PHYSICIAN, LLC |
| NPI Number: | 1093175804 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | EVILLO M DOMINGO (PRESIDENT) |
| Mailing Address: | 235 W Van Buren St 3107 Chicago |
| State: | IL US |
| Postal Code: | 606073918 |
| Phone Number: | 5672246045 |
| Fax Number: | |
| NPI Enumeration Date: | 03/07/2016 |
| NPI Last Update Date: | 03/07/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |