Healthcare Provider Details

I. General information

NPI: 1053129171
Provider Name (Legal Business Name): JINGYOU ZHU PSY.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/20/2024
Last Update Date: 12/20/2024
Certification Date: 12/20/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2400 RAVINE WAY STE 600
GLENVIEW IL
60025-7615
US

IV. Provider business mailing address

8000 LINCOLN AVE APT 720
SKOKIE IL
60077-1406
US

V. Phone/Fax

Practice location:
  • Phone: 651-200-1660
  • Fax:
Mailing address:
  • Phone: 651-200-1660
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number071.011343
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: