Individual provider Active NPI

Gerald W. Zachar, LCSW

  • Clinical Social Worker
  • Rolling Meadows, IL
National Provider Identifier
1497909907
Registry record updated Sep 2, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149-010194 Issued in IL
Practice address
4200 Euclid Ave
Suite D
Rolling Meadows, IL 60008-2083
Phone
(847) 721-6466
NPI assigned
Nov 11, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 2, 2013

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 149-010194 IL Primary

Addresses

Primary practice location

4200 Euclid Ave
Suite D
Rolling Meadows, IL 60008-2083

Mailing address

391 N Pondview Dr
Palatine, IL 60067-8021
Phone (847) 721-6466

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
I20090611000146 IL Practitioner - Clinical Social Worker 1456401538 Practice locations: Rolling Meadows, IL

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

4200 Euclid Ave
Rolling Meadows, IL 60008-2083
Phone (847) 721-6466

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
149-010194ILMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1226361600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1378080000000",
    "number": "1497909907",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "391 N PONDVIEW DR",
            "city": "PALATINE",
            "state": "IL",
            "postal_code": "600678021",
            "telephone_number": "847-721-6466"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4200 EUCLID AVE",
            "address_2": "SUITE D",
            "city": "ROLLING MEADOWS",
            "state": "IL",
            "postal_code": "600082083",
            "telephone_number": "847-721-6466"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZACHAR",
        "first_name": "GERALD",
        "middle_name": "W.",
        "name_prefix": "Dr.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-11-11",
        "last_updated": "2013-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149-010194",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rolling Meadows, IL

Sources for this page

Verify at the official NPI Registry.