Healthcare Provider Details

I. General information

NPI: 1649188061
Provider Name (Legal Business Name): ZYRA Z SARPY
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/28/2026
Last Update Date: 09/15/2026
Certification Date: 09/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1014 1/2 NORTH BLVD APT 24
OAK PARK IL
60301-1259
US

IV. Provider business mailing address

1014 1/2 NORTH BLVD APT 24
OAK PARK IL
60301-1259
US

V. Phone/Fax

Practice location:
  • Phone: 815-212-0342
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number146018723
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: