NPI Code Detail JSON Logo

1003806548 NPI number — JERRY M. ZABIN MSW

NPI Number: 1003806548
Health Care Provider/Practitioner: JERRY M. ZABIN MSW

Information about “1003806548” NPI (JERRY M. ZABIN MSW) exists in 1003806548 in HTML format HTML  |  1003806548 in plain Text format TXT  |  1003806548 in PDF (Portable Document Format) PDF  |  1003806548 in an XML format XML  formats.

NPI Number : 1003806548 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1003806548",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "Y",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "ZABIN",
    "FirstName": "JERRY",
    "MiddleName": "M.",
    "NamePrefix": "MR.",
    "NameSuffix": null,
    "Credential": "MSW",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "4043 SUFFIELD CT",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "SKOKIE",
    "MailingAddressStateName": "IL",
    "MailingAddressPostalCode": "60076-1946",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "847-677-3055",
    "MailingAddressFaxNumber": "847-329-9316",
    "FirstLinePracticeLocationAddress": "9701 KNOX AVE",
    "SecondLinePracticeLocationAddress": "214",
    "PracticeLocationAddressCityName": "SKOKIE",
    "PracticeLocationAddressStateName": "IL",
    "PracticeLocationAddressPostalCode": "60076-1256",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "847-677-3055",
    "PracticeLocationAddressFaxNumber": "847-329-9316",
    "EnumerationDate": "10/26/2005",
    "LastUpdateDate": "07/08/2007",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "M",
    "Gender": "Male",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "1041C0700X",
        "TaxonomyName": "Clinical Social Worker",
        "LicenseNumber": null,
        "LicenseNumberStateCode": "IL",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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