Provider Demographics
NPI:1588852446
Name:IVKOVIC, ZRINKA (MA, LCSW)
Entity Type:Individual
Prefix:MS
First Name:ZRINKA
Middle Name:
Last Name:IVKOVIC
Suffix:
Gender:F
Credentials:MA, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2525 WEST PETERSON AVE
Mailing Address - Street 2:COMMUNITY COUNSELING CENTERS OF CHICAGO
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60659-4108
Mailing Address - Country:US
Mailing Address - Phone:773-506-2525
Mailing Address - Fax:773-765-0622
Practice Address - Street 1:2525 WEST PETERSON AVE
Practice Address - Street 2:COMMUNITY COUNSELING CENTERS OF CHICAGO
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60659-4108
Practice Address - Country:US
Practice Address - Phone:773-506-2525
Practice Address - Fax:773-765-0622
Is Sole Proprietor?:No
Enumeration Date:2007-10-04
Last Update Date:2007-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILK45470Medicare PIN