Provider Demographics
NPI:1265502959
Name:ZWEIG, KEVIN OLIVER (MD)
Entity type:Individual
Prefix:DR
First Name:KEVIN
Middle Name:OLIVER
Last Name:ZWEIG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:2850 WEST 95TH STREET
Mailing Address - Street 2:SUITE 12
Mailing Address - City:EVERGREEN PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60805-2727
Mailing Address - Country:US
Mailing Address - Phone:708-425-6800
Mailing Address - Fax:
Practice Address - Street 1:2850 WEST 95TH STREET
Practice Address - Street 2:SUITE 12
Practice Address - City:EVERGREEN PARK
Practice Address - State:IL
Practice Address - Zip Code:60805-2727
Practice Address - Country:US
Practice Address - Phone:708-425-6800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-09
Last Update Date:2009-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036062511207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
C45900Medicare UPIN
716800Medicare ID - Type Unspecified
1265502959Medicare NSC
0756440001Medicare NSC