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NPI Code Detail

MEDICARE: ZINA MANSOOR APRN

MEDICARE: ZINA MANSOOR APRN
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
1363LP0808XPsychiatric/Mental Health Nurse Practitioner209035510IL

General Provider Information

NPI Number : 1750017638
Entity Type Code : Individual
Provider Name (Legal Business Name) : ZINA MANSOOR APRN
Provider Business Mailing Address
First Line : 7101 N CICERO AVE STE 204
Second Line :
City : LINCOLNWOOD
State : IL
Zip : 60712-2112
Country : US
Telephone Number : 847-972-1135
Fax Number : 866-744-0950
Provider Business Practice Location Address
First Line : 6303 N CLARK ST
Second Line :
City : CHICAGO
State : IL
Zip : 60660-1203
Country : US
Telephone Number : 773-433-6210
Fax Number : 866-744-0950
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/25/2022
Last Update Date : 05/07/2026

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