Provider Demographics
NPI:1669039509
Name:KMZ WELLNESS PLLC
Entity Type:Organization
Organization Name:KMZ WELLNESS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KATHLEEN
Authorized Official - Middle Name:MARY
Authorized Official - Last Name:ZACHARY
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:847-507-8881
Mailing Address - Street 1:910 W SHILOH DR
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON HEIGHTS
Mailing Address - State:IL
Mailing Address - Zip Code:60004-2933
Mailing Address - Country:US
Mailing Address - Phone:847-507-8881
Mailing Address - Fax:
Practice Address - Street 1:579 N 1ST BANK DR STE 150
Practice Address - Street 2:
Practice Address - City:PALATINE
Practice Address - State:IL
Practice Address - Zip Code:60067-8102
Practice Address - Country:US
Practice Address - Phone:847-701-4452
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-05-28
Last Update Date:2022-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty