Provider Demographics
NPI:1427859271
Name:PUMPHREY, ZAKAIA
Entity type:Individual
Prefix:
First Name:ZAKAIA
Middle Name:
Last Name:PUMPHREY
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1428 QUAIL RUN DR
Mailing Address - Street 2:
Mailing Address - City:SAVOY
Mailing Address - State:IL
Mailing Address - Zip Code:61874-9681
Mailing Address - Country:US
Mailing Address - Phone:217-904-9106
Mailing Address - Fax:
Practice Address - Street 1:4108 FIELDSTONE RD STE A
Practice Address - Street 2:
Practice Address - City:CHAMPAIGN
Practice Address - State:IL
Practice Address - Zip Code:61822-8808
Practice Address - Country:US
Practice Address - Phone:217-904-9106
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-19
Last Update Date:2025-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician