Active NPI
John Francis Zagotta, PSYD
- Clinical Psychologist
- Chicago, IL
National Provider Identifier
1902827546
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- Practice address
- 8700 West Bryn Mawr Ave
Ste 800 South
Chicago, IL 60631 - Phone
- (877) 807-5120
- Fax
- (574) 258-1898
- NPI assigned
- Jul 21, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 20040933A | IN | |
| Clinical Psychologist | 103TC0700X | IL | Primary |
Addresses
Primary practice location
8700 West Bryn Mawr Ave
Ste 800 South
Chicago, IL 60631
Mailing address
8700 West Bryn Mawr Ave
Ste 800 South
Chicago, IL 60631
Phone (877) 807-5120
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 20040933A | IN | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153440000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1902827546",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8700 WEST BRYN MAWR AVE",
"address_2": "STE 800 SOUTH",
"city": "CHICAGO",
"state": "IL",
"postal_code": "60631",
"telephone_number": "877-807-5120",
"fax_number": "574-258-1898"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8700 WEST BRYN MAWR AVE",
"address_2": "STE 800 SOUTH",
"city": "CHICAGO",
"state": "IL",
"postal_code": "60631",
"telephone_number": "877-807-5120",
"fax_number": "574-258-1898"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ZAGOTTA",
"first_name": "JOHN",
"middle_name": "FRANCIS",
"name_prefix": "Mr.",
"credential": "PSYD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-21",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "IN",
"license": "20040933A",
"primary": false
},
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "IL",
"license": null,
"primary": true
}
],
"identifiers": [],
"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 Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.