Individual provider Active NPI

Robert Zak

  • Marriage & Family Therapist
  • Bartlett, IL
National Provider Identifier
1700417789
Registry record updated Jan 29, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
208.000729 Issued in IL
Practice address
250 S Il Route 59
Bartlett, IL 60103-1648
Phone
(630) 483-5799
NPI assigned
Jan 29, 2020
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 29, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 106H00000X 208.000729 IL Primary

Addresses

Primary practice location

250 S Il Route 59
Bartlett, IL 60103-1648

Mailing address

250 S Il Route 59
Bartlett, IL 60103-1648
Phone (630) 483-5799

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

State licenses

LicenseStateTypeSpecialty
208.000729ILMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Hanover Township Youth and Family Service PastSince Feb 2, 2020 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": "1580256000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1580256000000",
    "number": "1700417789",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 S IL ROUTE 59",
            "city": "BARTLETT",
            "state": "IL",
            "postal_code": "601031648",
            "telephone_number": "630-483-5799"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "250 S IL ROUTE 59",
            "city": "BARTLETT",
            "state": "IL",
            "postal_code": "601031648",
            "telephone_number": "630-483-5799"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZAK",
        "first_name": "ROBERT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-01-29",
        "last_updated": "2020-01-29",
        "certification_date": "2020-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Marriage & Family Therapist",
            "state": "IL",
            "license": "208.000729",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bartlett, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2020; 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.