Provider Demographics
NPI:1912028150
Name:ZABELSKI, MARY S
Entity Type:Individual
Prefix:
First Name:MARY
Middle Name:S
Last Name:ZABELSKI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6153 N NETTLETON AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60631-2513
Mailing Address - Country:US
Mailing Address - Phone:773-774-4742
Mailing Address - Fax:
Practice Address - Street 1:THE CHICAGO LIGHTHOUSE,
Practice Address - Street 2:1850 W. ROOSEVELT RD.
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60608
Practice Address - Country:US
Practice Address - Phone:312-666-1331
Practice Address - Fax:312-596-0103
Is Sole Proprietor?:No
Enumeration Date:2007-04-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist