Healthcare Provider Details

I. General information

NPI: 1467627778
Provider Name (Legal Business Name): KAREN ZUCKER M.S.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/28/2008
Last Update Date: 05/19/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9150 CRAWFORD AVE SUITE 206
SKOKIE IL
60076-1700
US

IV. Provider business mailing address

436 WOODLAND RD
HIGHLAND PARK IL
60035-5057
US

V. Phone/Fax

Practice location:
  • Phone: 847-679-1605
  • Fax:
Mailing address:
  • Phone: 847-433-5412
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code237600000X
TaxonomyAudiologist-Hearing Aid Fitter
License Number147000277
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: