Individual provider Active NPI

Zak Mucha, LCSW

  • Clinical Social Worker
  • Chicago, IL
National Provider Identifier
1306011317
Registry record updated Oct 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149012840 Issued in IL
Practice address
1122 W Catalpa Ave
Chicago, IL 60640-1472
Phone
(773) 273-0474
NPI assigned
Apr 30, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 21, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 149012840 IL Primary

Addresses

Primary practice location

1122 W Catalpa Ave
Chicago, IL 60640-1472

Mailing address

1122 W Catalpa Ave Ste 1W
Chicago, IL 60640-7023
Phone (773) 273-0474

Other identifiers 1

IdentifierTypeStateIssuer
149012840OtherILBLUE SHIELD BLUE CROSS

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
I20080521000702 IL Practitioner - Clinical Social Worker 1759450372 Practice locations: Chicago, IL

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1122 W Catalpa Ave
1W
Chicago, IL 60640-7023
Phone (773) 273-0474

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
149012840ILMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1209513600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761004800000",
    "number": "1306011317",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1122 W CATALPA AVE STE 1W",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606407023",
            "telephone_number": "773-273-0474"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1122 W CATALPA AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606401472",
            "telephone_number": "773-273-0474"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUCHA",
        "first_name": "ZAK",
        "name_prefix": "Mr.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-04-30",
        "last_updated": "2025-10-21",
        "certification_date": "2025-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149012840",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD BLUE CROSS",
            "identifier": "149012840",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.