Provider Demographics
NPI:1497909907
Name:ZACHAR, GERALD W (LCSW)
Entity Type:Individual
Prefix:DR
First Name:GERALD
Middle Name:W
Last Name:ZACHAR
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:391 N PONDVIEW DR
Mailing Address - Street 2:
Mailing Address - City:PALATINE
Mailing Address - State:IL
Mailing Address - Zip Code:60067-8021
Mailing Address - Country:US
Mailing Address - Phone:847-721-6466
Mailing Address - Fax:
Practice Address - Street 1:4200 EUCLID AVE
Practice Address - Street 2:SUITE D
Practice Address - City:ROLLING MEADOWS
Practice Address - State:IL
Practice Address - Zip Code:60008-2083
Practice Address - Country:US
Practice Address - Phone:847-721-6466
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-11
Last Update Date:2013-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL149-0101941041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical