MEDICARE: JIE ZHU PSYD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103T00000X	Psychologist	024530-01	NY
2	103TC0700X	Clinical Psychologist	071.010725	IL

General Provider Information

NPI Number	:	1366390064
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JIE ZHU PSYD

Provider Business Mailing Address
First Line	:	1245 S MICHIGAN AVE STE 216
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60605-2408
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1245 S MICHIGAN AVE STE 216
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60605-2408
Country	:	US
Telephone Number	:	872-216-9703
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/18/2026
Last Update Date	:	03/18/2026

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Directions to “ JIE ZHU PSYD” Practice Location

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