Healthcare Provider Details

I. General information

NPI: 1598566382
Provider Name (Legal Business Name): WEIQI ZHONG LSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/19/2025
Last Update Date: 03/19/2025
Certification Date: 03/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

218 W 26TH ST
CHICAGO IL
60616-2204
US

IV. Provider business mailing address

1400 S WABASH AVE APT 705
CHICAGO IL
60605-2993
US

V. Phone/Fax

Practice location:
  • Phone: 312-285-2287
  • Fax:
Mailing address:
  • Phone: 917-698-7942
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number150.115624
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: