Provider Demographics
NPI:1306083902
Name:ZIMA, ROBERT J (LCPC)
Entity type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:J
Last Name:ZIMA
Suffix:
Gender:M
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1307 NEW HAVEN DR
Mailing Address - Street 2:
Mailing Address - City:CARY
Mailing Address - State:IL
Mailing Address - Zip Code:60013-1805
Mailing Address - Country:US
Mailing Address - Phone:847-322-4591
Mailing Address - Fax:
Practice Address - Street 1:185 HERITAGE DR
Practice Address - Street 2:SUITE 1
Practice Address - City:CRYSTAL LAKE
Practice Address - State:IL
Practice Address - Zip Code:60014-8068
Practice Address - Country:US
Practice Address - Phone:847-322-4591
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-19
Last Update Date:2009-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180007062101YM0800X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health