Healthcare Provider Details

I. General information

NPI: 1255782827
Provider Name (Legal Business Name): ABIGAIL ZUREICH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/24/2016
Last Update Date: 06/24/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7925 LINCOLN AVE
SKOKIE IL
60077-3679
US

IV. Provider business mailing address

2600 N HAMPDEN CT APT. B7
CHICAGO IL
60614-4943
US

V. Phone/Fax

Practice location:
  • Phone: 877-691-7994
  • Fax:
Mailing address:
  • Phone: 773-620-0949
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number178005779
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: