Provider Demographics
NPI:1629319009
Name:ZEMBURSKI, MATTHEW (PMHNP-BC)
Entity Type:Individual
Prefix:MR
First Name:MATTHEW
Middle Name:
Last Name:ZEMBURSKI
Suffix:
Gender:M
Credentials:PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:734 W 47TH ST
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60609-4411
Mailing Address - Country:US
Mailing Address - Phone:773-537-3960
Mailing Address - Fax:
Practice Address - Street 1:734 W 47TH ST
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60609-4411
Practice Address - Country:US
Practice Address - Phone:773-537-3960
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-03-08
Last Update Date:2013-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209010222163WP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health