Provider Demographics
NPI:1033323027
Name:ZUCKERMAN, STEVEN (PHD)
Entity Type:Individual
Prefix:
First Name:STEVEN
Middle Name:
Last Name:ZUCKERMAN
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:623 GREGORY AVE
Mailing Address - Street 2:
Mailing Address - City:WILMETTE
Mailing Address - State:IL
Mailing Address - Zip Code:60091-3419
Mailing Address - Country:US
Mailing Address - Phone:847-853-8639
Mailing Address - Fax:847-251-7974
Practice Address - Street 1:333 N MICHIGAN AVE
Practice Address - Street 2:STE. #1801
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60601-3901
Practice Address - Country:US
Practice Address - Phone:847-853-8639
Practice Address - Fax:847-251-7974
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist