Healthcare Provider Details

I. General information

NPI: 1811003668
Provider Name (Legal Business Name): AMY MARIE ZURCHER RD LD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/22/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3001 GREEN BAY RD
NORTH CHICAGO IL
60064-3048
US

IV. Provider business mailing address

553 CHESTERFIELD LN
BARRINGTON IL
60010-6526
US

V. Phone/Fax

Practice location:
  • Phone: 847-688-1900
  • Fax:
Mailing address:
  • Phone: 847-550-1431
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: