MEDICARE: SUSAN ZEIGLER LLC

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	251S00000X	Community/Behavioral Health Agency	149010600	IL

General Provider Information

NPI Number	:	1972091080
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SUSAN ZEIGLER LLC

Provider Business Mailing Address
First Line	:	4320 W HENDERSON ST
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60641-4544
Country	:	US
Telephone Number	:	773-932-5008
Fax Number	:

Provider Business Practice Location Address
First Line	:	4507 N RAVENSWOOD AVE STE 104
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60640-5218
Country	:	US
Telephone Number	:	773-932-5008
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	SUSAN ZEIGLER
Credential	:	LCSW
Telephone Number	:	773-932-5008

Provider Enumeration Date	:	04/24/2018
Last Update Date	:	02/12/2026

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