Organization Active NPI

Merrill J Zahtz MD SC

  • Specialist
  • Skokie, IL
National Provider Identifier
1104076405
Registry record updated Sep 23, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
0360563631 Issued in IL
Legal business name
MERRILL J ZAHTZ MD SC
Practice address
8170 McCormick Blvd
Suite 204
Skokie, IL 60076-2961
Phone
(773) 621-6489
Fax
(847) 410-2041
NPI assigned
Sep 23, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 23, 2008

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

Authorized official

Name
Dr. Merrill Zahtz, MDNPI 1225097819
Title
Provider
Phone
(773) 621-6489

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193200000X MULTI-SPECIALTY GROUP 174400000X 0360563631 IL Primary

Addresses

Primary practice location

8170 McCormick Blvd
Suite 204
Skokie, IL 60076-2961

Mailing address

PO Box 597130
Chicago, IL 60659-7130
Phone (773) 621-6489

Other identifiers 1

IdentifierTypeStateIssuer
036056363MedicaidIL

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1222128000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1222128000000",
    "number": "1104076405",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 597130",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606597130",
            "telephone_number": "773-621-6489",
            "fax_number": "847-410-2041"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8170 MCCORMICK BLVD",
            "address_2": "SUITE 204",
            "city": "SKOKIE",
            "state": "IL",
            "postal_code": "600762961",
            "telephone_number": "773-621-6489",
            "fax_number": "847-410-2041"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MERRILL J ZAHTZ MD SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-09-23",
        "last_updated": "2008-09-23",
        "status": "A",
        "authorized_official_last_name": "ZAHTZ",
        "authorized_official_first_name": "MERRILL",
        "authorized_official_title_or_position": "PROVIDER",
        "authorized_official_telephone_number": "773-621-6489",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist",
            "state": "IL",
            "license": "0360563631",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036056363",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Skokie, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.