Healthcare Provider Details

I. General information

NPI: 1104104223
Provider Name (Legal Business Name): ZEREK MAYES MSW, LCSW
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: ZEREK MAYES EDD

II. Dates (important events)

Enumeration Date: 07/22/2011
Last Update Date: 04/28/2023
Certification Date: 04/28/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7652 BRITTANY CT
FRANKFORT IL
60423-2145
US

IV. Provider business mailing address

20015 S LAGRANGE RD # 1034
FRANKFORT IL
60423-3104
US

V. Phone/Fax

Practice location:
  • Phone: 779-216-5681
  • Fax:
Mailing address:
  • Phone: 779-216-5681
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number149024349
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: