Healthcare Provider Details

I. General information

NPI: 1457949216
Provider Name (Legal Business Name): MENGQI ZHU LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ELLA ZHU LCSW

II. Dates (important events)

Enumeration Date: 01/07/2021
Last Update Date: 08/22/2024
Certification Date: 08/22/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

155 N MICHIGAN AVE STE 380
CHICAGO IL
60601-7710
US

IV. Provider business mailing address

1421 S WABASH AVE APT 3W
CHICAGO IL
60605-2846
US

V. Phone/Fax

Practice location:
  • Phone: 312-928-9351
  • Fax:
Mailing address:
  • Phone: 312-928-9351
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number149.025376
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: