Provider Demographics
NPI:1003806548
Name:ZABIN, JERRY M (MSW)
Entity Type:Individual
Prefix:MR
First Name:JERRY
Middle Name:M
Last Name:ZABIN
Suffix:
Gender:M
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4043 SUFFIELD CT
Mailing Address - Street 2:
Mailing Address - City:SKOKIE
Mailing Address - State:IL
Mailing Address - Zip Code:60076-1946
Mailing Address - Country:US
Mailing Address - Phone:847-677-3055
Mailing Address - Fax:847-329-9316
Practice Address - Street 1:9701 KNOX AVE
Practice Address - Street 2:214
Practice Address - City:SKOKIE
Practice Address - State:IL
Practice Address - Zip Code:60076-1256
Practice Address - Country:US
Practice Address - Phone:847-677-3055
Practice Address - Fax:847-329-9316
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical