Provider Demographics
NPI:1528494069
Name:ZARANKIN, SUSANA (PSYD)
Entity type:Individual
Prefix:
First Name:SUSANA
Middle Name:
Last Name:ZARANKIN
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:950 W BERWYN AVE
Mailing Address - Street 2:SUITE 6
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60640-2580
Mailing Address - Country:US
Mailing Address - Phone:773-216-8456
Mailing Address - Fax:773-751-2250
Practice Address - Street 1:950 W BERWYN AVE
Practice Address - Street 2:SUITE 6
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60640-2580
Practice Address - Country:US
Practice Address - Phone:773-216-8456
Practice Address - Fax:773-751-2250
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-16
Last Update Date:2013-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL071005550103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical