Healthcare Provider Details

I. General information

NPI: 1649026097
Provider Name (Legal Business Name): ALANA ZUCKER
Entity Type: Individual
Gender:
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/26/2024
Last Update Date: 04/26/2024
Certification Date: 04/26/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2835 N SHEFFIELD AVE # 513-514
CHICAGO IL
60657-5081
US

IV. Provider business mailing address

5100 N RAVENSWOOD AVE # 206-219
CHICAGO IL
60640-1710
US

V. Phone/Fax

Practice location:
  • Phone: 773-830-4199
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: