Provider Demographics
NPI:1053394437
Name:ZAJAKOWSKI UHLL, AMY LYN (LCPC)
Entity type:Individual
Prefix:
First Name:AMY
Middle Name:LYN
Last Name:ZAJAKOWSKI UHLL
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1422 W HIGHLAND
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60660
Mailing Address - Country:US
Mailing Address - Phone:773-465-2179
Mailing Address - Fax:
Practice Address - Street 1:671 N WABASH AVE
Practice Address - Street 2:ST JOHNS CATHEDRAL COUNSELING CENTER
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60611
Practice Address - Country:US
Practice Address - Phone:312-337-5874
Practice Address - Fax:312-337-9243
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-11-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional