Provider Demographics
NPI:1720455223
Name:ZALESNA, AGNES
Entity Type:Individual
Prefix:
First Name:AGNES
Middle Name:
Last Name:ZALESNA
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 1:2101 S ARLINGTON HEIGHTS RD STE 116
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON HEIGHTS
Mailing Address - State:IL
Mailing Address - Zip Code:60005-4142
Mailing Address - Country:US
Mailing Address - Phone:847-666-5339
Mailing Address - Fax:
Practice Address - Street 1:2101 S ARLINGTON HEIGHTS RD STE 116
Practice Address - Street 2:
Practice Address - City:ARLINGTON HEIGHTS
Practice Address - State:IL
Practice Address - Zip Code:60005-4142
Practice Address - Country:US
Practice Address - Phone:847-666-5339
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-09-01
Last Update Date:2023-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180009797101YP2500X
IL071010993103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional