Healthcare Provider Details

I. General information

NPI: 1396066791
Provider Name (Legal Business Name): NANCY BETH ZINAMAN LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/20/2010
Last Update Date: 06/20/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

602 HINMAN AVE 2 SOUTH
EVANSTON IL
60202-4602
US

IV. Provider business mailing address

602 HINMAN AVE 2 SOUTH
EVANSTON IL
60202-4602
US

V. Phone/Fax

Practice location:
  • Phone: 847-977-6430
  • Fax:
Mailing address:
  • Phone: 847-977-6430
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number149005345
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: