Individual provider Active NPI

Sandra Gabriele Zakowski, PHD

  • Clinical Psychologist
  • Chicago, IL
National Provider Identifier
1982958112
Registry record updated Apr 8, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
071007501 Issued in IL
Practice address
180 N Michigan Ave Ste 905
Chicago, IL 60601-7454
Phone
(773) 848-2768
NPI assigned
Nov 9, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 8, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 071007501 IL Primary

Addresses

Primary practice location

180 N Michigan Ave Ste 905
Chicago, IL 60601-7454

Mailing address

1614 N Wood St
Chicago, IL 60622-1326
Phone (773) 848-2768

Other identifiers 1

IdentifierTypeStateIssuer
12441219OtherILCAQH

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
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
071007501ILMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Sandra Zakowski PHD Inc Clinical 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": "1352419200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1554681600000",
    "number": "1982958112",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1614 N WOOD ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606221326",
            "telephone_number": "773-848-2768"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "180 N MICHIGAN AVE STE 905",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606017454",
            "telephone_number": "773-848-2768"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZAKOWSKI",
        "first_name": "SANDRA",
        "middle_name": "GABRIELE",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-11-09",
        "last_updated": "2019-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": "071007501",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "12441219",
            "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 Apr 8, 2019; 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.