Provider Information for 1386979102
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Mr. THOMAS CHESTER ZIMM L.C.S.W
Sex: Male
NPI: 1386979102
Last Updated: 2023-07-24
Certification Date: 2023-07-24
Certification Date: 2023-07-24
Details
| Name | Value | ||||||||
|---|---|---|---|---|---|---|---|---|---|
| NPI | 1386979102 | ||||||||
| Enumeration Date | 2009-10-13 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | YES | ||||||||
| Status | Active | ||||||||
| Mailing Address | 11560 S KEDZIE AVE MERRIONETTE PARK, IL 60803-4517 United States Phone: 708-974-5825 | Fax: | ||||||||
| Primary Practice Address | 11560 S KEDZIE AVE MERRIONETTE PARK, IL 60803-4517 United States Phone: 708-974-5825 | Fax: | ||||||||
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