Individual provider Active NPI

Martha Ellen Zuehlke, MD

  • Child & Adolescent Psychiatry Physician
  • Chicago, IL
National Provider Identifier
1376643650
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X
License
036056657 Issued in IL
Practice address
645 N Michigan Ave
Suite 820
Chicago, IL 60611-2826
Phone
(312) 988-7880
Fax
(708) 386-8363
NPI assigned
Sep 25, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 036056657 IL
Child & Adolescent Psychiatry Physician 2084P0804X 036056657 IL Primary

Addresses

Primary practice location

645 N Michigan Ave
Suite 820
Chicago, IL 60611-2826

Mailing address

842 Fair Oaks Ave
Oak Park, IL 60302-1547
Phone (312) 988-7880

Other identifiers 1

IdentifierTypeStateIssuer
036056657MedicaidIL

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)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
036056657ILMDChild & Adolescent Psychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lavoll and Edger, S.C. Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1159142400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1376643650",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "842 FAIR OAKS AVE",
            "city": "OAK PARK",
            "state": "IL",
            "postal_code": "603021547",
            "telephone_number": "312-988-7880",
            "fax_number": "708-386-8363"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "645 N MICHIGAN AVE",
            "address_2": "SUITE 820",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606112826",
            "telephone_number": "312-988-7880",
            "fax_number": "708-386-8363"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZUEHLKE",
        "first_name": "MARTHA",
        "middle_name": "ELLEN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-09-25",
        "last_updated": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "IL",
            "license": "036056657",
            "primary": false
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "IL",
            "license": "036056657",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036056657",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; 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.