Individual
MR. TIMOTHY JAMES ZENNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
C.A.D.C.
Contact information
Practice address
6027 N KENMORE AVE, CHICAGO, IL 60660-2953
(773) 506-7507
(773) 506-8275
Mailing address
1722 W NORTH SHORE AVE APT 2E, CHICAGO, IL 60626-4028
(773) 506-7507
(773) 506-8275
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
17602
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
101YA0400X
—
IL
Enumeration date
04/18/2007
Last updated
07/09/2007
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