Provider Demographics
NPI:1790437739
Name:ZEIDAN, AMEIR
Entity Type:Individual
Prefix:
First Name:AMEIR
Middle Name:
Last Name:ZEIDAN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1560 HEARTHSTONE LN
Mailing Address - Street 2:
Mailing Address - City:NORTH AURORA
Mailing Address - State:IL
Mailing Address - Zip Code:60542-6615
Mailing Address - Country:US
Mailing Address - Phone:708-802-4045
Mailing Address - Fax:
Practice Address - Street 1:1560 HEARTHSTONE LN
Practice Address - Street 2:
Practice Address - City:NORTH AURORA
Practice Address - State:IL
Practice Address - Zip Code:60542-6615
Practice Address - Country:US
Practice Address - Phone:708-802-4045
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-01-20
Last Update Date:2022-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1490241851041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical