Healthcare Provider Details

I. General information

NPI: 1518593706
Provider Name (Legal Business Name): ANTHONY RAY ZWAGA LCSW
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/19/2020
Last Update Date: 11/06/2025
Certification Date: 11/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

820 N. ORLEANS STREET SUITE 350
CHICAGO IL
60610
US

IV. Provider business mailing address

1333 N KINGSBURY ST STE 303
CHICAGO IL
60642-2687
US

V. Phone/Fax

Practice location:
  • Phone: 312-809-0298
  • Fax:
Mailing address:
  • Phone: 312-809-0298
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: