Provider Demographics
NPI:1053877811
Name:ZARRABI, ROXANA (PSYD)
Entity type:Individual
Prefix:
First Name:ROXANA
Middle Name:
Last Name:ZARRABI
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:ROXY
Other - Middle Name:
Other - Last Name:ZARRABI
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:25 E WASHINGTON ST STE 1717
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60602-1839
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:25 E WASHINGTON ST STE 1717
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60602-1839
Practice Address - Country:US
Practice Address - Phone:708-967-3417
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-02-18
Last Update Date:2019-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL071.009967103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical