Healthcare Provider Details

I. General information

NPI: 1386386332
Provider Name (Legal Business Name): DR. MICHAEL ZAKALIK, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/11/2022
Last Update Date: 04/12/2022
Certification Date: 04/12/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2027 W DIVISION ST STE 243
CHICAGO IL
60622-9024
US

IV. Provider business mailing address

2027 W DIVISION ST STE 243
CHICAGO IL
60622-9024
US

V. Phone/Fax

Practice location:
  • Phone: 773-234-1835
  • Fax:
Mailing address:
  • Phone: 773-234-1835
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code103TC2200X
TaxonomyClinical Child & Adolescent Psychologist
License Number
License Number State

VIII. Authorized Official

Name: DR. MICHAEL ZAKALIK
Title or Position: CLINICAL PSYCHOLOGIST/OWNER
Credential: PSYD
Phone: 773-234-1835