Individual provider Active NPI

Michelle Marie Zadelek, M.A.

  • Mental Health Counselor
  • Forest Park, IL
National Provider Identifier
1356704209
Registry record updated Mar 29, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
8311 Roosevelt Rd
Forest Park, IL 60130-2529
Phone
(708) 771-7000
NPI assigned
Mar 29, 2016
Last updated
Mar 29, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 29, 2016

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 Primary

Addresses

Primary practice location

8311 Roosevelt Rd
Forest Park, IL 60130-2529

Mailing address

3709 Kenilworth Ave
Berwyn, IL 60402-3909
Phone (708) 710-6869

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Arts

NPI Registry JSON

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

{
    "created_epoch": "1459209600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1459209600000",
    "number": "1356704209",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3709 KENILWORTH AVE",
            "city": "BERWYN",
            "state": "IL",
            "postal_code": "604023909",
            "telephone_number": "708-710-6869"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8311 ROOSEVELT RD",
            "city": "FOREST PARK",
            "state": "IL",
            "postal_code": "601302529",
            "telephone_number": "708-771-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZADELEK",
        "first_name": "MICHELLE",
        "middle_name": "MARIE",
        "credential": "M.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-03-29",
        "last_updated": "2016-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Forest Park, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2016; 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.