Healthcare Provider Details

I. General information

NPI: 1750017638
Provider Name (Legal Business Name): ZINA MANSOOR APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/25/2022
Last Update Date: 05/07/2026
Certification Date: 05/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6303 N CLARK ST
CHICAGO IL
60660-1203
US

IV. Provider business mailing address

7101 N CICERO AVE STE 204
LINCOLNWOOD IL
60712-2112
US

V. Phone/Fax

Practice location:
  • Phone: 773-433-6210
  • Fax: 866-744-0950
Mailing address:
  • Phone: 847-972-1135
  • Fax: 866-744-0950

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number209035510
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: