IBRAHIM OMAR ZACHARIA SR.
Complete NPI Record 1548652431
Behavior Analyst in Chicago, IL
NPI Status: Active since March 02, 2015
Contact Information
1327 W SHERWIN AVE APT GB
CHICAGO, IL
ZIP 60626
Phone: (520) 302-0336
- NPI
- Entity Type Code
- Provider Last Name Legal Name
- Provider First Name
- Provider Middle Name
- Provider Name Suffix Text
- Provider First Line Business Mailing Address
- Provider Business Mailing Address City Name
- Provider Business Mailing Address State Name
- Provider Business Mailing Address Postal Code
- Provider Business Mailing Address Country Code If outside U S
- Provider Business Mailing Address Telephone Number
- Provider First Line Business Practice Location Address
- Provider Business Practice Location Address City Name
- Provider Business Practice Location Address State Name
- Provider Business Practice Location Address Postal Code
- Provider Business Practice Location Address Country Code If outside U S
- Provider Business Practice Location Address Telephone Number
- Provider Enumeration Date
- Last Update Date
- Provider Gender Code
- Healthcare Provider Taxonomy Code 1
- Provider License Number 1
- Provider License Number State Code 1
- Healthcare Provider Primary Taxonomy Switch 1
- Is Sole Proprietor
Complete NPI Dataset
This page represents the complete record for NPI 1548652431. You can access the complete dataset, including a full list of field names, along with their values, and definitions as recorded by the NPI registry. Each field in the NPI record is explained, highlighting its significance and the possible values it can hold.
- NPI: 1548652431
- The date the provider was assigned a unique identifier (assigned an NPI).
- Entity Type Code: 1
- The date that a record was last updated or changed.
- Provider Last Name Legal Name: ZACHARIA
- The code designating the provider’s gender if the provider is a person.
- Provider First Name: IBRAHIM
- Code designating the provider type, classification, and specialization. Codes are from the Healthcare Provider Taxonomy code list. The NPS will associate these data with the license data for providers with Entity type code = 1.
- Provider Middle Name: OMAR
- The middle name of the provider, if the provider is an individual.
- Provider Name Suffix Text: SR.
- The name suffix of the provider if the provider is an individual. The name suffix is a ‘‘generation-related’’ suffix, such as Jr., Sr., II, III, IV, or V.
- Provider First Line Business Mailing Address: 1327 W SHERWIN AVE APT GB
- The first line mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider first line location address’’.
- Provider Business Mailing Address City Name: CHICAGO
- The city name in the mailing address of the provider being identified.
- Provider Business Mailing Address State Name: IL
- The State or Province name in the mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address State name’’.
- Provider Business Mailing Address Postal Code: 606262021
- The postal ZIP or zone code in the mailing address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available. This data element may contain the same information as ‘‘Provider location address postal code’’.
- Provider Business Mailing Address Country Code If outside U S : US
- The country code in the mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address country code’’.
- Provider Business Mailing Address Telephone Number: 5203020336
- The telephone number associated with mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address telephone number’’.
- Provider First Line Business Practice Location Address: 1327 W SHERWIN AVE APT GB
- The first line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
- Provider Business Practice Location Address City Name: CHICAGO
- The city name in the location address of the provider being identified.
- Provider Business Practice Location Address State Name: IL
- The State code in the location of the provider being identified.
- Provider Business Practice Location Address Postal Code: 606262021
- The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available.
- Provider Business Practice Location Address Country Code If outside U S : US
- The country code in the location address of the provider being identified.
- Provider Business Practice Location Address Telephone Number: 5203020336
- The telephone number associated with the location address of the provider being identified.
- Provider Enumeration Date: 3/2/2015
- The date the provider was assigned a unique identifier (assigned an NPI).
- Last Update Date: 3/2/2015
- The date that a record was last updated or changed.
- Provider Gender Code: M
- The code designating the provider’s gender if the provider is a person.
- Healthcare Provider Taxonomy Code 1: 103K00000X
- Code designating the provider type, classification, and specialization. Codes are from the Healthcare Provider Taxonomy code list. The NPS will associate these data with the license data for providers with Entity type code = 1.
- Provider License Number 1: 472020968
- The license number issued to the provider being identified. The NPS can accommodate multiple license numbers for multiple specialties and for multiple States. The NPS will associate this data element with ‘‘provider taxonomy code’’.
- Provider License Number State Code 1: IL
- The 10-position all-numeric identification number assigned by the NPS to uniquely identify a health care provider. The NPI number includes an ISO standard check-digit in the 10th position. There is no intelligence about the health care provider in the number.
- Healthcare Provider Primary Taxonomy Switch 1: Y
- Code describing the type of health care provider that is being assigned an NPI. Codes are 1 = (Person): individual human being who furnishes health care; 2 = (Non-person): entity other than an individual human being that furnishes health care (for example, hospital, SNF, hospital subunit, pharmacy, or HMO).
- Is Sole Proprietor: N
- The last name of the provider. If the provider is an individual, this is the legal name.