MEDICARE: DR. JOHN CHARLES ZIBERT PH.D; LCPC

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	101YM0800X	Mental Health Counselor	180-004874	IL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	180-004874	OTHER	IL	IL BOARD FINAN & PROF REG

General Provider Information

NPI Number	:	1073624060
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOHN CHARLES ZIBERT PH.D; LCPC

Provider Business Mailing Address
First Line	:	6536 N ASHLAND AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60626-4907
Country	:	US
Telephone Number	:	773-960-2762
Fax Number	:	888-635-6531

Provider Business Practice Location Address
First Line	:	6536 N ASHLAND AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60626-4907
Country	:	US
Telephone Number	:	773-960-2762
Fax Number	:	888-635-6531

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

Provider Enumeration Date	:	08/31/2006
Last Update Date	:	01/14/2025

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