Provider Demographics
NPI:1497474506
Name:ZIMMER, MARNY MURPHY (MSW)
Entity Type:Individual
Prefix:
First Name:MARNY
Middle Name:MURPHY
Last Name:ZIMMER
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:928 ASHLAND AVE
Mailing Address - Street 2:
Mailing Address - City:WILMETTE
Mailing Address - State:IL
Mailing Address - Zip Code:60091-1738
Mailing Address - Country:US
Mailing Address - Phone:312-497-0813
Mailing Address - Fax:
Practice Address - Street 1:928 ASHLAND AVE
Practice Address - Street 2:
Practice Address - City:WILMETTE
Practice Address - State:IL
Practice Address - Zip Code:60091-1738
Practice Address - Country:US
Practice Address - Phone:312-497-0813
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-23
Last Update Date:2022-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL150.108778104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker