Provider Demographics
NPI:1285956508
Name:ZION, SIDRA
Entity type:Individual
Prefix:
First Name:SIDRA
Middle Name:
Last Name:ZION
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:SIDRA
Other - Middle Name:
Other - Last Name:ROTHMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:9144 MASON AVE
Mailing Address - Street 2:
Mailing Address - City:MORTON GROVE
Mailing Address - State:IL
Mailing Address - Zip Code:60053-2459
Mailing Address - Country:US
Mailing Address - Phone:847-583-9724
Mailing Address - Fax:
Practice Address - Street 1:9144 MASON AVE
Practice Address - Street 2:
Practice Address - City:MORTON GROVE
Practice Address - State:IL
Practice Address - Zip Code:60053-2459
Practice Address - Country:US
Practice Address - Phone:847-583-9724
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-01
Last Update Date:2010-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist