Provider Demographics
NPI:1609339704
Name:SANDRA ZAKOWSKI PHD INC
Entity Type:Organization
Organization Name:SANDRA ZAKOWSKI PHD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ACCOUNTANT
Authorized Official - Prefix:
Authorized Official - First Name:IRA
Authorized Official - Middle Name:
Authorized Official - Last Name:DUBIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:847-647-0250
Mailing Address - Street 1:1614 N WOOD ST
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60622-1326
Mailing Address - Country:US
Mailing Address - Phone:773-848-2768
Mailing Address - Fax:
Practice Address - Street 1:180 N MICHIGAN AVE STE 905
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60601-7454
Practice Address - Country:US
Practice Address - Phone:773-848-2768
Practice Address - Fax:312-453-0224
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-04-08
Last Update Date:2019-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL1982958112OtherTYPE 1 NPI NUMBER