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General NPI Number Information
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NPI Number | 1023475381
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Entity Type | Individual
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Provider Name | ZAKIYA GILLIAM M.S.
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Gender | Female
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Dates
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Enumeration Date | 01/18/2016
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Last Update Date | 01/18/2016
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Provider Practice Location Address
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Address Line | 6501 S PROMONTORY DR
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City | CHICAGO
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State | IL
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Zip | 60649-1003
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Country | US
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Telephone | 773-753-8635
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Fax | 773-363-7905
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Provider Business Mailing Address
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Address Line | 5208 RIDGE AVE APT 1
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City | HILLSIDE
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State | IL
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Zip | 60162-1062
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Country | US
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Telephone | 708-200-2934
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 222Q00000X
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Taxonomy Name | Developmental Therapist
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License Number |
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License Number State | IL
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