Jose Zavala, LCSW is a medicare enrolled "Social Worker - Clinical" provider in Oak Park, Illinois. His current practice location is
14 Lake St, Oak Park, Illinois. You can reach out to his office (for appointments etc.) via phone at
(773) 584-4178.
Jose Zavala is licensed to practice in Illinois (license number 149025090) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1205571171.
Healthcare Provider's Profile
| Full Name | Jose Zavala |
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| Gender | Male |
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| Speciality | Social Worker - Clinical |
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| Location | 14 Lake St, Oak Park, Illinois |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1205571171
- Provider Enumeration Date: 05/04/2022
- Last Update Date: 01/30/2023
Medicare PECOS Information:
- PECOS PAC ID: 8921541624
- Enrollment ID: I20240624000059
Medical Identifiers
Medical identifiers for Jose Zavala such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1205571171 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 101Y00000X | Counselor | 149025090 (Illinois) | Secondary |
| 1041C0700X | Social Worker - Clinical | 149025090 (Illinois) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Jose Zavala allows following entities to bill medicare on his behalf.
| Entity Name | Pcc Community Wellness Center |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1871516799
PECOS PAC ID: 1557270139
Enrollment ID: O20040206000415 |
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| Entity Name | Esperanza Health Centers |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1124187125
PECOS PAC ID: 2961453105
Enrollment ID: O20050204000750 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Jose Zavala is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Jose Zavala, LCSW
14 Lake St,
Oak Park, IL 60302-2606
Ph: () - | Jose Zavala, LCSW
14 Lake St,
Oak Park, IL 60302-2606
Ph: (773) 584-4178 |
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