Individual
DR. ZACHARY DAVID MICHALICEK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
2650 RIDGE AVE, EVANSTON, IL 60201-1718
(847) 570-2779
Mailing address
7625 N EASTLAKE TER APT 106, CHICAGO, IL 60626-1469
(515) 770-6288
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
125061507
IL
Other
Enumeration date
06/21/2012
Last updated
06/21/2012
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