Provider Demographics
NPI:1619204930
Name:NEMAZEE, ASHLEY E (BA)
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:E
Last Name:NEMAZEE
Suffix:
Gender:F
Credentials:BA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2801 S KING DR
Mailing Address - Street 2:APT 1601
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60616-2949
Mailing Address - Country:US
Mailing Address - Phone:708-358-3000
Mailing Address - Fax:
Practice Address - Street 1:115 S MARION ST STE 1
Practice Address - Street 2:
Practice Address - City:OAK PARK
Practice Address - State:IL
Practice Address - Zip Code:60302-2826
Practice Address - Country:US
Practice Address - Phone:708-358-3000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-11-06
Last Update Date:2009-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst