Individual
IBRAHIM OMAR ZACHARIA SR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1327 W SHERWIN AVE APT GB, CHICAGO, IL 60626-2021
(520) 302-0336
Mailing address
1327 W SHERWIN AVE APT GB, CHICAGO, IL 60626-2021
(520) 302-0336
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
472020968
IL
Other
Enumeration date
03/02/2015
Last updated
03/02/2015
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