DR. JEANETTE ZWICKY SIMON (NPI# 1346768017) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1346768017 |
Entity Type | Individual |
Full Name | DR. JEANETTE ZWICKY SIMON |
Credential | PSY.D. ,C.A.D.C. |
Practice Address |
1100 Lake Street Suite 210 B Oak Park IL 60301 |
Practice Telephone | 7086287578 |
Mailing Telephone | 7086287578 |
Enumeration Date | 2017-09-01 |
Last Update Date | 2018-01-08 |
NPI Deactivation Date | 11/08/2017 |
NPI Reactivation Date | 2018-01-08 |
Gender Code | F |
Is Sole Proprietor | Y |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 103TC0700X |
Psychologist Specialization: Clinical |
071.005823 | IL | Behavioral Health & Social Service Providers |
Street Address |
1100 LAKE STREET SUITE 210 B |
City | OAK PARK |
State | IL |
Zip Code | 60301 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1295884559 | Terry Lou Stagman | Psychologist | 1100 Lake Street, Suite Ll38, Oak Park, IL 60301-1015 | 2007-01-09 |
1578043121 | Ava Marvin | Music Therapist | 1100 Lake Street, Suite 100c, Oak Park, IL 60301 | 2018-08-14 |
1205371853 | Aerie Ventures LLC | Home Health | 1100 Lake Street, Suite 130, Oak Park, IL 60301-1002 | 2017-01-05 |
1548441959 | Ability Healthcare, Ltd | Chiropractor | 1100 Lake Street, Suite 120, Oak Park, IL 60301 | 2007-11-14 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1457982332 | Heather Lea Corwin | Counselor | Blackbird Behavioral Health, 715 Lake Street, 4th Floor, Oak Park, IL 60301 | 2020-01-30 |
1194244400 | Kristin Burns Mind and Body | Clinic/Center | 715 Lake St Ste 703, Oak Park, IL 60301 | 2017-09-18 |
1538686357 | Highland Park Cvs LLC | Durable Medical Equipment & Medical Supplies | 1129 Lake St., Oak Park, IL 60301 | 2017-08-23 |
1851835888 | Wanda Secthecia Presley | Nurse's Aide | 1140 South Lake Street, Oak Park, IL 60301 | 2016-12-09 |
1477914323 | Naomi Elise Heinz | Occupational Therapist | 820 North Boulevard, Kids Unlimited Therapy Services, LLC, Oak Park, IL 60301 | 2016-03-18 |
1316339518 | Christina Shrader | Counselor | 137 N Oak Park Ave Ste 123, Oak Park, IL 60301 | 2015-02-24 |
1356755334 | Grief Recovery Group, Inc | Social Worker | 1010 Lake Street, Suite 620, Oak Park, IL 60301 | 2014-06-17 |
1700137239 | Christine Marie Hare | Nurse Practitioner | 1100 Lake St Ste 120, Oak Park, IL 60301 | 2012-09-24 |
1427334622 | Ina N. Owens | Social Worker | 137 N. Oak Park Ave, Oak Park, IL 60301 | 2011-11-01 |
1265720130 | Debora S Crowley | Occupational Therapist | 820 North Blvd., Oak Park, IL 60301 | 2011-07-13 |
Find all providers in zip 60301 |
Taxonomy Code | 103TC0700X |
Grouping | Behavioral Health & Social Service Providers |
Classification | Psychologist |
Specialization | Clinical |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1710511514 | Kirsten T Svejda, Psyd, LLC | Psychologist | 101 N Marion St Ste 202, Oak Park, IL 60301-1023 | 2020-03-02 |
1497397228 | Priebe Psychological & Wellness | Psychologist | 101 N Marion St Ste 201, Oak Park, IL 60301-1023 | 2019-10-14 |
1487200861 | Lisa Lombard | Psychologist | 332 N Scoville Ave, Oak Park, IL 60302-2263 | 2019-08-12 |
1376015396 | Susan Longley | Psychologist | 851 Washington Blvd Apt A2, Oak Park, IL 60302-3851 | 2019-01-02 |
1942703632 | Jaclyn Marie Patricia Fleck | Psychologist | 806 North Blvd Apt 202, Oak Park, IL 60301-1383 | 2018-03-09 |
1992162721 | Caitlin Wurster | Psychologist | 137 N Oak Park Ave Ste 302, Oak Park, IL 60301-1339 | 2016-01-25 |
1548636541 | Kari Terrill | Psychologist | 610 S Maple Ave Ste 5601, Oak Park, IL 60304-1091 | 2015-08-13 |
1386903193 | Amanda Kim | Psychologist | 530 Washington Blvd Apt 3e, Oak Park, IL 60302-4063 | 2012-05-14 |
1578839585 | Olga Mikhaylovna Slavin-spenny | Psychologist | 25900 Greenfield Rd Ste 502, Oak Park, MI 48237-1890 | 2012-03-25 |
1457639619 | James Galezewski and Associates | Psychologist | 1045 S Ridgeland Ave, Oak Park, IL 60304-2123 | 2011-07-21 |
Find all providers in OAK PARK |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.