Provider Demographics
NPI:1134537830
Name:ZISKIND, VICTORIA (LMT)
Entity type:Individual
Prefix:
First Name:VICTORIA
Middle Name:
Last Name:ZISKIND
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:VICTORIA
Other - Middle Name:
Other - Last Name:PEYSAKHOVA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMT
Mailing Address - Street 1:880 LEE ST STE 207
Mailing Address - Street 2:
Mailing Address - City:DES PLAINES
Mailing Address - State:IL
Mailing Address - Zip Code:60016-6465
Mailing Address - Country:US
Mailing Address - Phone:847-768-9330
Mailing Address - Fax:847-768-9336
Practice Address - Street 1:880 LEE ST STE 207
Practice Address - Street 2:
Practice Address - City:DES PLAINES
Practice Address - State:IL
Practice Address - Zip Code:60016-6465
Practice Address - Country:US
Practice Address - Phone:847-768-9330
Practice Address - Fax:847-768-9336
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-25
Last Update Date:2014-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL227002315225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist