Basic Information
Provider Information
NPI: 1811003668
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ZURCHER
FirstName: AMY
MiddleName: MARIE
NamePrefix: MS.
NameSuffix:  
Credential: RD LD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 553 CHESTERFIELD LN
Address2:  
City: BARRINGTON
State: IL
PostalCode: 600106526
CountryCode: US
TelephoneNumber: 8475501431
FaxNumber:  
Practice Location
Address1: 3001 GREEN BAY RD
Address2:  
City: NORTH CHICAGO
State: IL
PostalCode: 600643048
CountryCode: US
TelephoneNumber: 8476881900
FaxNumber:  
Other Information
ProviderEnumerationDate: 08/22/2006
LastUpdateDate: 07/08/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
133V00000X ILY Dietary & Nutritional Service ProvidersDietitian, Registered 

No ID Information.


Home