Healthcare Provider Details

I. General information

NPI: 1033323027
Provider Name (Legal Business Name): STEVEN ZUCKERMAN PH.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/09/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

333 N MICHIGAN AVE STE. #1801
CHICAGO IL
60601-3901
US

IV. Provider business mailing address

623 GREGORY AVE
WILMETTE IL
60091-3419
US

V. Phone/Fax

Practice location:
  • Phone: 847-853-8639
  • Fax: 847-251-7974
Mailing address:
  • Phone: 847-853-8639
  • Fax: 847-251-7974

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: