Provider Demographics
NPI:1104104223
Name:MAYES, ZEREK (MSW, LCSW)
Entity type:Individual
Prefix:
First Name:ZEREK
Middle Name:
Last Name:MAYES
Suffix:
Gender:M
Credentials:MSW, LCSW
Other - Prefix:DR
Other - First Name:ZEREK
Other - Middle Name:
Other - Last Name:MAYES
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:EDD
Mailing Address - Street 1:20015 S LAGRANGE RD # 1034
Mailing Address - Street 2:
Mailing Address - City:FRANKFORT
Mailing Address - State:IL
Mailing Address - Zip Code:60423-3104
Mailing Address - Country:US
Mailing Address - Phone:779-216-5681
Mailing Address - Fax:
Practice Address - Street 1:7652 BRITTANY CT
Practice Address - Street 2:
Practice Address - City:FRANKFORT
Practice Address - State:IL
Practice Address - Zip Code:60423-2145
Practice Address - Country:US
Practice Address - Phone:779-216-5681
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-07-22
Last Update Date:2023-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101Y00000X
IL1490243491041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101Y00000XBehavioral Health & Social Service ProvidersCounselor