Doctor Name: | HECTOR R ZAVALA |
NPI Number: | 1679852255 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | LCPC |
License Number: | 180008993 |
Business Practice Address: | 89 Cedar Ave Lake Villa, IL - 600468411 |
Business Phone Number: | 8472657300 |
Business Fax Number: | 8472657301 |
Mailing Address: | 449 S Ardmore Ter, ADDISON |
State: | IL |
Postal Code: | 601014188 |
Phone Number: | 6307506896 |
Fax Number: | |
NPI Enumeration Date: | 08/12/2011 |
NPI Last Update Date: | 02/26/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YP2500X |
License Number: | 180008993 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IL |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Professional |
Taxonomy Definition: |