Healthcare Provider Details

I. General information

NPI: 1962127175
Provider Name (Legal Business Name): QING ZHANG
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/10/2022
Last Update Date: 05/20/2026
Certification Date: 05/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 4TH AVE
JOLIET IL
60433-1901
US

IV. Provider business mailing address

284 WESTBROOK CIR
NAPERVILLE IL
60565-3270
US

V. Phone/Fax

Practice location:
  • Phone: 815-723-3409
  • Fax:
Mailing address:
  • Phone: 312-998-9678
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code103TS0200X
TaxonomySchool Psychologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: