Provider Demographics
NPI:1295913598
Name:ZENDER, REBECCA ELIZABETH (MA LPC, MS CCC-SLP)
Entity type:Individual
Prefix:MS
First Name:REBECCA
Middle Name:ELIZABETH
Last Name:ZENDER
Suffix:
Gender:F
Credentials:MA LPC, MS CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24194 N GRANDVIEW DR
Mailing Address - Street 2:
Mailing Address - City:LAKE BARRINGTON
Mailing Address - State:IL
Mailing Address - Zip Code:60010-1737
Mailing Address - Country:US
Mailing Address - Phone:414-336-9293
Mailing Address - Fax:
Practice Address - Street 1:500 COVENTRY LN STE 170
Practice Address - Street 2:
Practice Address - City:CRYSTAL LAKE
Practice Address - State:IL
Practice Address - Zip Code:60014-7592
Practice Address - Country:US
Practice Address - Phone:815-356-2700
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-08
Last Update Date:2022-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL146.016570235Z00000X
WI171M00000X171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
No171M00000XOther Service ProvidersCase Manager/Care Coordinator
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI314-226OtherPCTL