MEDICARE: ZEBULON HEALTH SOLUTIONS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YP1600X	Pastoral Counselor
2	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1114744711
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ZEBULON HEALTH SOLUTIONS

Provider Business Mailing Address
First Line	:	11001 S MICHIGAN AVE # 36
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60628-4308
Country	:	US
Telephone Number	:	773-809-1670
Fax Number	:

Provider Business Practice Location Address
First Line	:	11001 S MICHIGAN AVE # 36
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60628-4308
Country	:	US
Telephone Number	:	773-809-1670
Fax Number	:

Authorized Official
Title or Position	:	FOUNDER
Name	:	MRS. LASHAWN M WALLACE
Credential	:
Telephone Number	:	773-809-1670

Provider Enumeration Date	:	09/24/2024
Last Update Date	:	06/12/2026

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