Provider Demographics
NPI:1992208078
Name:ZIMMERMAN, SARAH (MA)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:
Last Name:ZIMMERMAN
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6639 N KEDZIE AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60645-4161
Mailing Address - Country:US
Mailing Address - Phone:773-765-3132
Mailing Address - Fax:312-553-5466
Practice Address - Street 1:6639 N KEDZIE AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60645-4161
Practice Address - Country:US
Practice Address - Phone:773-765-3132
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-03-14
Last Update Date:2018-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional