Organization Active NPI

KMZ Wellness PLLC

  • Clinical Psychologist
  • Palatine, IL
National Provider Identifier
1669039509
Registry record updated Feb 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
Legal business name
KMZ WELLNESS PLLC
Practice address
579 N 1St Bank Dr Ste 150
Palatine, IL 60067-8102
Phone
(847) 701-4452
NPI assigned
May 28, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 15, 2022

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

Authorized official

Name
Kathleen Mary Zachary, PSY.D.
Title
Owner
Phone
(847) 507-8881

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103TC0700X Primary

Addresses

Primary practice location

579 N 1St Bank Dr Ste 150
Palatine, IL 60067-8102

Mailing address

910 W Shiloh Dr
Arlington Heights, IL 60004-2933
Phone (847) 507-8881

National Provider Directory

National Provider Directory

Locations

579 N 1st Bank Dr
Ste 150
Palatine, IL 60067
Phone (847) 701-4273

NPI Registry JSON

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

{
    "created_epoch": "1559001600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1644883200000",
    "number": "1669039509",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "910 W SHILOH DR",
            "city": "ARLINGTON HEIGHTS",
            "state": "IL",
            "postal_code": "600042933",
            "telephone_number": "847-507-8881"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "579 N 1ST BANK DR STE 150",
            "city": "PALATINE",
            "state": "IL",
            "postal_code": "600678102",
            "telephone_number": "847-701-4452"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KMZ WELLNESS PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-05-28",
        "last_updated": "2022-02-15",
        "certification_date": "2022-02-15",
        "status": "A",
        "authorized_official_last_name": "ZACHARY",
        "authorized_official_first_name": "KATHLEEN",
        "authorized_official_middle_name": "MARY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "847-507-8881",
        "authorized_official_credential": "PSY.D."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palatine, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2022; 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.