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General NPI Number Information
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NPI Number | 1902827546
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Entity Type | Individual
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Provider Name | JOHN FRANCIS ZAGOTTA PSYD
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Gender | Male
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Dates
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Enumeration Date | 07/21/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 8700 WEST BRYN MAWR AVE STE 800 SOUTH
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City | CHICAGO
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State | IL
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Zip | 60631
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Country | US
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Telephone | 877-807-5120
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Fax | 574-258-1898
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Provider Business Mailing Address
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Address Line | 8700 WEST BRYN MAWR AVE STE 800 SOUTH
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City | CHICAGO
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State | IL
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Zip | 60631
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Country | US
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Telephone | 877-807-5120
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Fax | 574-258-1898
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 20040933A
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License Number State | IN
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Taxonomy #2
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number |
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License Number State | IL
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