Provider Demographics
NPI:1063086429
Name:HUBBARD, ZACHARIAH ALLEN
Entity type:Individual
Prefix:
First Name:ZACHARIAH
Middle Name:ALLEN
Last Name:HUBBARD
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6116 N WINTHROP AVE APT 2W
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60660-2637
Mailing Address - Country:US
Mailing Address - Phone:844-359-7629
Mailing Address - Fax:
Practice Address - Street 1:6116 N WINTHROP AVE APT 2W
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60660-2637
Practice Address - Country:US
Practice Address - Phone:844-359-7629
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-05-19
Last Update Date:2025-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician
Provider Identifiers
StateIdentifier IDID TypeIssuer
RBT-20-145217OtherRBT CREDENTIALS