Provider Demographics
NPI:1174861736
Name:ZEITNER, SUSAN E (LCSW)
Entity type:Individual
Prefix:
First Name:SUSAN
Middle Name:E
Last Name:ZEITNER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 RAVINIA PL
Mailing Address - Street 2:
Mailing Address - City:ORLAND PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60462-3758
Mailing Address - Country:US
Mailing Address - Phone:708-460-9833
Mailing Address - Fax:708-460-1117
Practice Address - Street 1:3330 W 177TH ST
Practice Address - Street 2:SUITE 1F
Practice Address - City:HAZEL CREST
Practice Address - State:IL
Practice Address - Zip Code:60429-2184
Practice Address - Country:US
Practice Address - Phone:708-745-3040
Practice Address - Fax:708-799-1889
Is Sole Proprietor?:No
Enumeration Date:2013-01-16
Last Update Date:2013-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL149.0114651041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical