Provider Demographics
NPI:1639441587
Name:ZACHARIAS, JEFFREY WILLIAM (LCSW, CADC)
Entity Type:Individual
Prefix:MR
First Name:JEFFREY
Middle Name:WILLIAM
Last Name:ZACHARIAS
Suffix:
Gender:M
Credentials:LCSW, CADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2576 W ARGYLE ST UNIT 2
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60625-2604
Mailing Address - Country:US
Mailing Address - Phone:773-720-0068
Mailing Address - Fax:
Practice Address - Street 1:2420 W WINNEMAC AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60625-2614
Practice Address - Country:US
Practice Address - Phone:773-720-0068
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-02-07
Last Update Date:2020-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL149.0150421041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical