Provider Demographics
NPI:1871864074
Name:ZAJAK, NICHOLAS G SR (MA, LCPC)
Entity Type:Individual
Prefix:MR
First Name:NICHOLAS
Middle Name:G
Last Name:ZAJAK
Suffix:SR
Gender:M
Credentials:MA, LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7213 W BREEN ST
Mailing Address - Street 2:
Mailing Address - City:NILES
Mailing Address - State:IL
Mailing Address - Zip Code:60714-2203
Mailing Address - Country:US
Mailing Address - Phone:847-309-7852
Mailing Address - Fax:
Practice Address - Street 1:3436 N KENNICOTT AVE
Practice Address - Street 2:
Practice Address - City:ARLINGTON HEIGHTS
Practice Address - State:IL
Practice Address - Zip Code:60004-7814
Practice Address - Country:US
Practice Address - Phone:847-952-7460
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-01-19
Last Update Date:2016-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health