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General NPI Number Information
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NPI Number | 1093584708
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Entity Type | Individual
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Provider Name | JILL EILEEN ZAKON LEONARD
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Gender | Female
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Dates
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Enumeration Date | 12/21/2023
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Last Update Date | 12/21/2023
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Provider Practice Location Address
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Address Line | 825 GREEN BAY RD STE 200
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City | WILMETTE
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State | IL
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Zip | 60091-2500
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Country | US
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Telephone | 847-251-6630
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Fax |
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Provider Business Mailing Address
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Address Line | 1850 GREEN BAY RD APT 304
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City | HIGHLAND PARK
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State | IL
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Zip | 60035-3466
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Country | US
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Telephone | 847-772-7766
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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 | 104100000X
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Taxonomy Name | Social Worker
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License Number | 150.106618
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License Number State | IL
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