Provider Demographics
NPI:1932229127
Name:ZULASKI, MARGARET MARY (PSYD)
Entity Type:Individual
Prefix:DR
First Name:MARGARET
Middle Name:MARY
Last Name:ZULASKI
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 667
Mailing Address - Street 2:26 W 171 ROOSEVELT ROAD
Mailing Address - City:WHEATON
Mailing Address - State:IL
Mailing Address - Zip Code:60189-0667
Mailing Address - Country:US
Mailing Address - Phone:630-462-4934
Mailing Address - Fax:630-462-7148
Practice Address - Street 1:26W171 ROOSEVELT RD
Practice Address - Street 2:
Practice Address - City:WHEATON
Practice Address - State:IL
Practice Address - Zip Code:60187-6078
Practice Address - Country:US
Practice Address - Phone:630-462-4934
Practice Address - Fax:630-462-7148
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL016-05015OtherBLUE CROSS BLUE SHEILD
IL404190Medicare ID - Type UnspecifiedPSYCHOTHERAPY