Healthcare Provider Details

I. General information

NPI: 1013483155
Provider Name (Legal Business Name): ANUM ZAFAR LCSW-149.030595
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/16/2018
Last Update Date: 01/03/2026
Certification Date: 01/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5 REVERE DR STE 120
NORTHBROOK IL
60062-8005
US

IV. Provider business mailing address

5 REVERE DR STE 120
NORTHBROOK IL
60062-8005
US

V. Phone/Fax

Practice location:
  • Phone: 847-306-9843
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number149.030595
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: