Zachary David Michalicek, D.O.

Primary specialty

Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X

License

125061507 Issued in IL

Practice address

2650 Ridge Ave
Evanston, IL 60201-1718

Phone

(847) 570-2779

NPI assigned

Jun 21, 2012

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

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

{
    "created_epoch": "1340236800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1340236800000",
    "number": "1134482318",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7625 N EASTLAKE TER APT 106",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606261469",
            "telephone_number": "515-770-6288"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2650 RIDGE AVE",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602011718",
            "telephone_number": "847-570-2779"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MICHALICEK",
        "first_name": "ZACHARY",
        "middle_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-06-21",
        "last_updated": "2012-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "IL",
            "license": "125061507",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michael a Conforti LCSW Inc
• Michael England, Psy.D., P.C.
• Michael J Verta Jr, MDSC
• Michael W Frank M D LLC
• Amanda L. Michalek, APN-CNP
• Michelle Ferris, LCSW, PLLC
• Margaret Gross Michelson, M.D.
• Lisa Marie Michener, PHARM.D., M.S.
• Amanda Micklo, DO
• Kathleen Patricia Mickow, FNP-BC

• Anatomic Pathology & Clinical Pathology Physician in Evanston, IL
• Providers in Evanston, IL by specialty
• Anatomic Pathology & Clinical Pathology Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2012; 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.