Healthcare Provider Details

I. General information

NPI: 1265409106
Provider Name (Legal Business Name): JOYCE E ZICK LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 02/28/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

333 S STATE ST REVENUE #200 CHICAGO DEPARTMENT OF PUBLIC HEALTH
CHICAGO IL
60604
US

IV. Provider business mailing address

333 S STATE ST REVENUE #200 CHICAGO DEPARTMENT OF PUBLIC HEALTH
CHICAGO IL
60604
US

V. Phone/Fax

Practice location:
  • Phone: 312-747-9443
  • Fax: 312-747-9447
Mailing address:
  • Phone: 312-747-9443
  • Fax: 312-747-9447

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: