Healthcare Provider Details

I. General information

NPI: 1821810516
Provider Name (Legal Business Name): HUEDA ZATAR
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/25/2024
Last Update Date: 10/25/2024
Certification Date: 10/25/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11301 S HARLEM AVE
WORTH IL
60482-2001
US

IV. Provider business mailing address

15721 LAKE HILLS CT
ORLAND PARK IL
60462-7922
US

V. Phone/Fax

Practice location:
  • Phone: 708-586-2604
  • Fax:
Mailing address:
  • Phone: 708-971-5555
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: