Provider Demographics
NPI:1053520999
Name:BALOCH, ZAFAR
Entity type:Individual
Prefix:MR
First Name:ZAFAR
Middle Name:
Last Name:BALOCH
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8908 MIDDLETON RD
Mailing Address - Street 2:
Mailing Address - City:DARIEN
Mailing Address - State:IL
Mailing Address - Zip Code:60561-8441
Mailing Address - Country:US
Mailing Address - Phone:630-915-6102
Mailing Address - Fax:
Practice Address - Street 1:8908 MIDDLETON RD
Practice Address - Street 2:
Practice Address - City:DARIEN
Practice Address - State:IL
Practice Address - Zip Code:60561-8441
Practice Address - Country:US
Practice Address - Phone:630-915-6102
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist