Provider Demographics
NPI:1649485228
Name:ZUCHEL, ANTOINETTE JOSEPHINA (LCPC)
Entity type:Individual
Prefix:MRS
First Name:ANTOINETTE
Middle Name:JOSEPHINA
Last Name:ZUCHEL
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:MRS
Other - First Name:TINA
Other - Middle Name:JOSEPHINA
Other - Last Name:ZUCHEL
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LCPC
Mailing Address - Street 1:412 BELDEN AVE
Mailing Address - Street 2:
Mailing Address - City:GLENDALE HEIGHTS
Mailing Address - State:IL
Mailing Address - Zip Code:60139-2510
Mailing Address - Country:US
Mailing Address - Phone:630-415-0343
Mailing Address - Fax:
Practice Address - Street 1:1555 N NAPERVILLE WHEATON RD
Practice Address - Street 2:STE 103
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60563-1557
Practice Address - Country:US
Practice Address - Phone:630-415-0343
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL02232564OtherBLUE CROSS BLUE SHEILD #