Allergy Clinic of Livingston County PC

Primary specialty

Allergy & Immunology PhysicianTaxonomy code 207K00000X

License

MZ035093 Issued in MI

Legal business name

ALLERGY CLINIC OF LIVINGSTON COUNTY PC

Practice address

8619 W Grand River Ave
Ste. J
Brighton, MI 48116-2334

Phone

(810) 227-6793

Fax

(810) 227-5397

NPI assigned

May 16, 2007

Last updated

Mar 25, 2009By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Mark N Zacks, M.D.NPI 1881658953

Title

Owner

Phone

(810) 227-6793

Specialties & licenses 1

Addresses

Other identifiers 7

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Mark N Zacks, M.D.

  • Allergy & Immunology Physician
  • Brighton, MI
  • NPI 1881658953
  NPD (past) Authorized official

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

{
    "created_epoch": "1179273600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1237939200000",
    "number": "1154538619",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8619 W GRAND RIVER AVE",
            "address_2": "STE. J",
            "city": "BRIGHTON",
            "state": "MI",
            "postal_code": "481162334",
            "telephone_number": "810-227-6793",
            "fax_number": "810-227-5397"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8619 W GRAND RIVER AVE",
            "address_2": "STE. J",
            "city": "BRIGHTON",
            "state": "MI",
            "postal_code": "481162334",
            "telephone_number": "810-227-6793",
            "fax_number": "810-227-5397"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALLERGY CLINIC OF LIVINGSTON COUNTY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-16",
        "last_updated": "2009-03-25",
        "status": "A",
        "authorized_official_last_name": "ZACKS",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "N",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "810-227-6793",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207K00000X",
            "taxonomy_group": "",
            "desc": "Allergy & Immunology",
            "state": "MI",
            "license": "MZ035093",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GREAT LAKES",
            "identifier": "2924",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CARE NETWORK",
            "identifier": "700D711040",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HAP",
            "identifier": "93648A",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "700D711040",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CHAMPUS",
            "identifier": "M011067",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "11217890",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4840320",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Elizabeth Ahearn
• Brian Ahmedani, PHD, LMSW
• Johnathan Jordan Albertson
• Alexander Hunt, PLLC
• Grace Allen, MSW
• Alliance Physician Services of Michigan, P.C. (Michigan Institute of Urology)
• Tracey Nicole Alperin, MD
• Ithar Alsarraf
• Hugo Alvarez, M.D.
• Fatima Aman Siddiqui, M.D

• Allergy & Immunology Physician in Brighton, MI
• Providers in Brighton, MI by specialty
• Allergy & Immunology Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2009; 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.