Provider Demographics
NPI:1205181328
Name:ZINZER, ANGELA SUE (LCSW)
Entity Type:Individual
Prefix:
First Name:ANGELA
Middle Name:SUE
Last Name:ZINZER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7225 DIVISION ST APT 3
Mailing Address - Street 2:
Mailing Address - City:RIVER FOREST
Mailing Address - State:IL
Mailing Address - Zip Code:60305-1248
Mailing Address - Country:US
Mailing Address - Phone:469-585-4431
Mailing Address - Fax:
Practice Address - Street 1:6201 CERMAK RD
Practice Address - Street 2:
Practice Address - City:BERWYN
Practice Address - State:IL
Practice Address - Zip Code:60402-2331
Practice Address - Country:US
Practice Address - Phone:708-788-8808
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-14
Last Update Date:2012-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL149.0153751041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical