Healthcare Provider Details

I. General information

NPI: 1588189971
Provider Name (Legal Business Name): SAMANTHA ZUREK LCPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: SAMANTHA ABERLY

II. Dates (important events)

Enumeration Date: 08/07/2017
Last Update Date: 08/11/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1805 N MILL ST STE B
NAPERVILLE IL
60563-4870
US

IV. Provider business mailing address

1275 N DOE RD
PALATINE IL
60067-1814
US

V. Phone/Fax

Practice location:
  • Phone: 630-639-2777
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number180.011074
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: