Healthcare Provider Details

I. General information

NPI: 1114334695
Provider Name (Legal Business Name): YUZHEN ZENG PMHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/17/2014
Last Update Date: 02/20/2020
Certification Date: 02/20/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

901 S AUSTIN BLVD
CHICAGO IL
60644-5311
US

IV. Provider business mailing address

4711 GOLF RD 1250
SKOKIE IL
60076-1224
US

V. Phone/Fax

Practice location:
  • Phone: 847-675-7979
  • Fax:
Mailing address:
  • Phone: 847-235-6130
  • Fax: 847-235-6135

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number209011630
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number209.011630
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: