Healthcare Provider Details

I. General information

NPI: 1699643353
Provider Name (Legal Business Name): NANZI ZHENG PHD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/24/2025
Last Update Date: 10/24/2025
Certification Date: 10/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2858 W DIVERSEY AVE
CHICAGO IL
60647-1871
US

IV. Provider business mailing address

2858 W DIVERSEY AVE
CHICAGO IL
60647-1871
US

V. Phone/Fax

Practice location:
  • Phone: 872-240-2636
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: