MARK A ZISSMAN (PSYD) – Clinical Psychologist, NPI 1033607031

MARK A ZISSMAN (PSYD) is a healthcare provider. based in Gurnee, Illinois. specializing in CLINICAL PSYCHOLOGIST. They hold the professional credentials PSYD. They hold a License No. 071.009193 (IL). The NPI Number for MARK A ZISSMAN (PSYD) is 1033607031

Main info

Male
Sole Proprietor
13 Years Of Experience
Accepts Medicare Assignment
Name
MARK A ZISSMAN (PSYD)
NPI
1033607031
Phone
(847) 356-8205
Address
222 S GREENLEAF ST STE 106
Enumeration Date
25 April 2018
Last Update Date
24 September 2018

Doctor Profile

Medical School Name
OTHER
Secondary Phone
2244336744
Graduation Year
2013 (13 years ago)
PAC ID
7517353808
Group Practice PAC ID
5991858516
Professional Enrollment ID
I20220427001169
Address ID
IL600483936LI1248XWAYX300
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience30
Completeness75
Years active:8State licenses:1Digital endpointsOther names

1,600 CLINICAL PSYCHOLOGIST in IL

Provider Addresses for MARK A ZISSMAN (PSYD)

  • 222 S GREENLEAF ST STE 106

    GURNEE, IL 600315705

    Phone: (847) 356-8205

    Type: Location

  • 3204 EAGLE WAY

    CHICAGO, IL 606781032

    Phone: (630) 717-2258

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2022-04-27

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20220427001169IClinical PsychologistILTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 60031)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 5991858516View full group profile
NameSpecialtyState
Clinical PsychologistIL
Clinical Social WorkerIL
Clinical PsychologistIL

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Frequently asked questions

What is the 10-digit NPI for MARK A ZISSMAN (PSYD)?
MARK A ZISSMAN (PSYD) — NPI 1033607031 — is the standard way to identify this listing.
Is MARK A ZISSMAN (PSYD) listed as active for patients and plans?
The listing shows MARK A ZISSMAN (PSYD) as active in the NPI system.
What is MARK A ZISSMAN (PSYD)'s specialty?
The listing groups MARK A ZISSMAN (PSYD) with Clinical Psychologist. Clinical services aligned with this taxonomy classification.
What address line appears for MARK A ZISSMAN (PSYD)?
MARK A ZISSMAN (PSYD)'s geographic hint is Gurnee, Illinois in our summary view.
What does 'Individual Provider' mean on this profile?
Entity type tells you whether the number belongs to a person or an organization.

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