Healthcare Provider Details

I. General information

NPI: 1811571870
Provider Name (Legal Business Name): KATARYNA ZAPALA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/06/2021
Last Update Date: 05/06/2021
Certification Date: 05/06/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6500 W 95TH ST
OAK LAWN IL
60453-2167
US

IV. Provider business mailing address

6500 W 95TH ST
OAK LAWN IL
60453-2167
US

V. Phone/Fax

Practice location:
  • Phone: 708-599-1050
  • Fax:
Mailing address:
  • Phone: 708-599-1050
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TS0200X
TaxonomySchool Psychologist
License Number931893
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: