Basic Information
| Provider Information | |||||||||
| NPI: | 1891128492 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ZARTUCHE | ||||||||
| FirstName: | ANGELA | ||||||||
| MiddleName: | M | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | PSY D | ||||||||
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| Mailing Information | |||||||||
| Address1: | 20 N CLARK ST STE 2650 | ||||||||
| Address2: | |||||||||
| City: | CHICAGO | ||||||||
| State: | IL | ||||||||
| PostalCode: | 606025104 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8662965262 | ||||||||
| FaxNumber: | 8779918819 | ||||||||
| Practice Location | |||||||||
| Address1: | 20 N CLARK ST STE 2650 | ||||||||
| Address2: | |||||||||
| City: | CHICAGO | ||||||||
| State: | IL | ||||||||
| PostalCode: | 606025104 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8662965262 | ||||||||
| FaxNumber: | 8779918819 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/19/2013 | ||||||||
| LastUpdateDate: | 08/12/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 08/12/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 103T00000X | N | Behavioral Health & Social Service Providers | Psychologist | 1041C0700X | IL | Y | Behavioral Health & Social Service Providers | Social Worker | Clinical |
No ID Information.