Individual provider Active NPI

John Charles Zibert, PH.D; LCPC

  • Mental Health Counselor
  • Chicago, IL
National Provider Identifier
1073624060
Registry record updated Jan 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
180-004874 Issued in IL
Practice address
6536 N Ashland Ave
Chicago, IL 60626-4907
Phone
(773) 960-2762
Fax
(888) 635-6531
NPI assigned
Aug 31, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 14, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 180-004874 IL Primary

Addresses

Primary practice location

6536 N Ashland Ave
Chicago, IL 60626-4907

Mailing address

6536 N Ashland Ave
Chicago, IL 60626-4907
Phone (773) 960-2762

Other identifiers 1

IdentifierTypeStateIssuer
180-004874OtherILIL BOARD FINAN & PROF REG

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240401000508 IL Practitioner - Mental Health Counselor 6901244698 Practice locations: Chicago, IL

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

6536 N Ashland Ave
Chicago, IL 60626-4907
Phone (773) 960-2762

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
180-004874ILMDMental Health Counselor

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736812800000",
    "number": "1073624060",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6536 N ASHLAND AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606264907",
            "telephone_number": "773-960-2762",
            "fax_number": "888-635-6531"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6536 N ASHLAND AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606264907",
            "telephone_number": "773-960-2762",
            "fax_number": "888-635-6531"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZIBERT",
        "first_name": "JOHN",
        "middle_name": "CHARLES",
        "name_prefix": "Dr.",
        "credential": "PH.D; LCPC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-31",
        "last_updated": "2025-01-14",
        "certification_date": "2025-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IL",
            "license": "180-004874",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IL BOARD FINAN & PROF REG",
            "identifier": "180-004874",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.