MEDICARE: DR. MICHAEL J ZAKALIK PSYD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103TC2200X	Clinical Child & Adolescent Psychologist	071009039	IL
2	103TC0700X	Clinical Psychologist	071009039	IL

General Provider Information

NPI Number	:	1164738548
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MICHAEL J ZAKALIK PSYD

Provider Business Mailing Address
First Line	:	2027 W DIVISION ST STE 243
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60622-9024
Country	:	US
Telephone Number	:	773-665-8052
Fax Number	:

Provider Business Practice Location Address
First Line	:	2027 W DIVISION ST STE 243
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60622-9024
Country	:	US
Telephone Number	:	773-234-1835
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/24/2010
Last Update Date	:	08/28/2022

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