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NPI Code Detail

MEDICARE: MARY S. ZABELSKI

MEDICARE:   MARY S. ZABELSKI
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
1222Q00000XDevelopmental Therapist

General Provider Information

NPI Number : 1912028150
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARY S. ZABELSKI
Provider Business Mailing Address
First Line : 6153 N NETTLETON AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60631-2513
Country : US
Telephone Number : 773-774-4742
Fax Number :
Provider Business Practice Location Address
First Line : THE CHICAGO LIGHTHOUSE,
Second Line : 1850 W. ROOSEVELT RD.
City : CHICAGO
State : IL
Zip : 60608
Country : US
Telephone Number : 312-666-1331
Fax Number : 312-596-0103
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/03/2007
Last Update Date : 07/08/2007

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